Conversation 9 | Higher Cortical Dysfunction

What you will learnThis episode reviews the original paper proposing the Status Epilepticus Severity Score, or STESS score, for prognosis in adult patients with status epilepticus. It explains how consciousness level, seizure type, age, and seizure history were used to predict short-term mortality.Key wordsConsciousness impairment.Non-convulsive status epilepticus with coma.Negative predictive value.Somnolent.Stuporous.Comatose.Post-anoxic.SourceRossetti AO, Logroscino G, Bromfield EB. A clinical score for prognosis of status epilepticus in adults. Neurology. 2006;66:1736-1738.NoteThis episode is for educational purposes only. This is a summary and commentary, not the original article.

What you will learnThis episode reviews a study proposing the modified Status Epilepticus Severity Score, or modified S-T-E-S-S, for predicting mortality in adult patients with status epilepticus. It explains how adding baseline mRS may improve early risk prediction.Key wordsStatus epilepticus.S-T-E-S-S score.Modified S-T-E-S-S.Modified Rankin Scale.Non-convulsive status epilepticus with coma.Baseline functional status.SourceGonzalez-Cuevas M, Santamarina E, Toledo M, et al. A new clinical score for the prognosis of status epilepticus in adults. European Journal of Neurology. 2016;23:1534-1540. doi:10.1111/ene.13073.NoteThis episode is for educational purposes only. This is a summary and commentary, not the original article.

What you will learnThis episode reviews a prospective study on neurological autoantibodies in adult patients with epilepsy of unknown etiology. It explains why autoimmune epilepsy is clinically important and highlights red flags such as viral prodrome, faciobrachial dystonic spells, facial dyskinesias, and the APE score.Key wordsEpilepsy of unknown etiology.Neurological autoantibodies.Viral prodrome.Faciobrachial dystonic spells.Facial dyskinesias.APE score.SourceDubey D, Alqallaf A, Hays R, et al. Neurological Autoantibody Prevalence in Epilepsy of Unknown Etiology. JAMA Neurology. 2017;74(4):397-402. doi:10.1001/jamaneurol.2016.5429.NoteThis episode is for educational purposes only. This is a summary and commentary, not the original article.

What you will learnThis conversation introduces common types of higher cortical dysfunction, including aphasia, apraxia, agnosia, hemispatial neglect, memory impairment, and executive dysfunction.Key wordsHigher cortical function. Aphasia. Apraxia. Agnosia. Hemispatial neglect. Memory impairment. Executive dysfunction.SourceClinical neurological examination and standard clinical practice.NoteThis episode is for educational purposes only. This is a practice conversation, not a real clinical interaction.

What you will learnThis conversation introduces common autonomic symptoms and basic points of autonomic nervous system examination, including orthostatic hypotension, bladder dysfunction, constipation, sweating abnormality, and pupillary response.Key wordsAutonomic nervous system. Orthostatic hypotension. Postural dizziness. Urenary retention.Bladder dysfunction. Constipation. Sweating abnormality. Pupillary response.SourceClinical neurological examination and standard clinical practice.NoteThis episode is for educational purposes only. This is a practice conversation, not a real clinical interaction.

What you will learnThis conversation introduces how to ask about symptoms related to meningeal irritation and how to examine meningeal signs, including nuchal rigidity, jolt accentuation, Kernig sign, and Brudzinski sign.Key wordsMeningeal irritation. Nuchal rigidity. Jolt accentuation. Kernig sign. Brudzinski sign. Photophobia. Lumbar puncture.SourceClinical neurological examination and standard clinical practice.NoteThis episode is for educational purposes only. This is a practice conversation, not a real clinical interaction.

What you will learnThis conversation introduces a basiccoordination examination, including the finger-to-nose test, heel-to-shin test,rapid alternating movements, and common cerebellar signs.Key wordsFinger-to-nose test. Heel-to-shin test.Dysmetria. decomposition of movement. Dysdiadochokinesia. Intention tremor. Cerebellar ataxia.SourceClinical neurological examination andstandard clinical practice.NoteThis episode is for educational purposesonly. This is a practice conversation, not a real clinical interaction.

What you will learnThis conversation introduces common abnormal gait patterns and their associated neurological diseases.Key wordsSensory ataxia. Cerebellar ataxia. Spastic gait. Scissoring gait. Parkinsonian gait. Steppage gait. Intermittent claudication. Waddling gait.SourceClinical neurological examination and standard clinical practice.NoteThis episode is for educational purposes only. This is a practice conversation, not a real clinical interaction.

What you will learnThis conversation introduces how to perform a basic reflex examination, including deep tendon reflexes, the Jendrassik maneuver, and the Babinski reflex.Key wordsJaw jerk reflex. Biceps reflex. Patellar tendon reflex. Jendrassik maneuver. Babinski reflex.SourceClinical neurological examination and standard clinical practice.NoteThis episode is for educational purposes only. This is a practice conversation, not a real clinical interaction.

What you will learnThis conversation introduces how to askabout numbness and how to perform a basic sensory examination.Key wordsNumbness. Anesthesia. Dysesthesia. Pain andtemperature sensation. Joint position sense. Vibration sense.SourceClinical neurological examination andstandard clinical practice.NoteThis episode is for educational purposesonly. This is a practice conversation, not a real clinical interaction.