P1: OSO/OVY P2: OSO/OVY LWBK998-FM LWBK998-Lynn QC: OSO/OVY T1: OSO January 28, 2012 11:45 The 5-Minute Neurology Consult 2ND EDITION i P1: OSO/OVY P2: OSO/OVY LWBK998-FM LWBK998-Lynn QC: OSO/OVY T1: OSO January 28, 2012 11:45 ii P1: OSO/OVY P2: OSO/OVY LWBK998-FM LWBK998-Lynn QC: OSO/OVY April 4, 2012 T1: OSO 14:48 The 5-Minute Neurology Consult 2ND EDITION Editors D Joanne Lynn, MD Associate Dean for Student Life Clinical Professor of Neurology Ohio State University College of Medicine Columbus, Ohio Herbert B Newton, MD, FAAN Professor of Neurology, Neurosurgery, and Oncology Director, Division of Neuro-Oncology Esther Dardinger Endowed Chair in Neuro-Oncology Co-Director, Dardinger Neuro-Oncology Center Ohio State University Medical Center James Cancer Hospital Columbus, Ohio Alexander D Rae-Grant, MD, FRCP(C) Clinical Associate Professor of Medicine Cleveland Clinic Lerner College of Medicine of Case Western Reserve University Staff Neurologist, Neurological Institute Cleveland Clinic Cleveland, Ohio iii P1: OSO/OVY P2: OSO/OVY LWBK998-FM LWBK998-Lynn QC: OSO/OVY T1: OSO January 28, 2012 11:45 Acquisitions Editor: Frances Destefano Product Manager: Tom Gibbons Production Manager: Alicia Jackson Senior Manufacturing Manager: Benjamin Rivera Marketing Manager: Alexander Burns Design Coordinator: Teresa Mallon Production Service: Aptara, Inc C 2012 by LIPPINCOTT WILLIAMS & WILKINS, a WOLTERS KLUWER business Two Commerce Square 2001 Market Street Philadelphia, PA 19103 USA LWW.com First Edition C 2004 by LIPPINCOTT WILLIAMS & WILKINS All rights reserved This book is protected by copyright No part of this book may be reproduced in any form by any means, including photocopying, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews Materials appearing in this book prepared by individuals as part of their official duties as U.S government employees are not covered by the above-mentioned copyright Printed in China Library of Congress Cataloging-in-Publication Data The 5-minute neurology consult / [edited by] D Joanne Lynn, Herbert B Newton, Alexander D Rae-Grant – 2nd ed p ; cm Five-minute neurology consult Includes bibliographical references and index ISBN 978-1-4511-0012-9 (hardback) I Lynn, D Joanne II Newton, Herbert B III Rae-Grant, Alexander IV Title: Five-minute neurology consult [DNLM: Nervous System Diseases–therapy–Handbooks Nervous System Diseases–diagnosis–Handbooks Nervous System Diseases–physiopathology–Handbooks WL 39] 616.8–dc23 2012000593 Care has been taken to confirm the accuracy of the information presented and to describe generally accepted practices However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication Application of this information in a particular situation remains the professional responsibility of the practitioner The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance with current recommendations and practice at the time of publication However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions This is particularly important when the recommended agent is a new or infrequently employed drug Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA) clearance for limited use in restricted research settings It is the responsibility of the health care provider to ascertain the FDA status of each drug or device planned for use in their clinical practice To purchase additional copies of this book, call our customer service department at (800) 638-3030 or fax orders to (301) 223-2320 International customers should call (301) 223-2300 Visit Lippincott Williams & Wilkins on the Internet: http://www.LWW.com Lippincott Williams & Wilkins customer service representatives are available from 8:30 am to 6:00 pm, EST 10 iv P1: OSO/OVY P2: OSO/OVY LWBK998-FM LWBK998-Lynn QC: OSO/OVY T1: OSO January 28, 2012 11:45 To the many patients, students, mentors, and others who bring inspiration and grace into my life, including John Kissel, Miriam Freimer, Dan Clinchot, Ralph Jozefowicz ´ and Sheryl Pfeil, Jeffrey Huntley, and, most of all, to my daughters Kate and Patty who never fail to bring the blessing of love to each of my days —D.J.L To my children, Alex and Ashley, for their love, support, and patience In addition, I’d like to thank all of my neuro-oncology patients for their courage and inspiration —H.B.N To my family, colleagues, and particularly to my patients, with gratitude —A.D.R-G v P1: OSO/OVY P2: OSO/OVY LWBK998-FM LWBK998-Lynn QC: OSO/OVY T1: OSO January 28, 2012 11:45 vi P1: OSO/OVY P2: OSO/OVY LWBK998-FM LWBK998-Lynn QC: OSO/OVY T1: OSO January 28, 2012 11:45 CONTRIBUTORS LIST Foad I Abandeh, MBBS Fellow Division of Infectious Diseases The Ohio State University Medical Center Columbus, Ohio Tauseef Afaqa, MD Sleep Fellow Department of Internal Medicine The Ohio State University The Ohio State University Medical Center Columbus, Ohio Puja Aggarwal, MD Resident Department of Neurology Ohio State University Ohio State University Medical Center Columbus, Ohio Punit Agrawal, DO Clinical Assistant Professor Department of Neurology The Ohio State University Medical Center Columbus, Ohio Anwar Ahmed, MD Fellowship Director Movement Disorder Center for Neurological Restoration Staff Neurologist Department of Neurology Cleveland Clinic Cleveland, Ohio James W Albers, MD Emeritus Professor of Neurology Department of Neurology University of Michigan Medical School Attending Physician Department of Neurology University of Michigan Health System Ann Arbor, Michigan Tamer Ammar, MD Stroke Neurologist Department of Neurology UMC Las Vegas, Nevada Monique A Anawis, MD, JD Assistant Professor of Clinical Ophthalmology Department of Ophthalmology Northwestern University Feinberg School of Medicine Medical Staff and Teaching Faculty Department of Surgery and Medicine Weiss Memorial Hospital Chicago, Illinois Peter J Barbour, MD Associate Professor Department of Neurology University of South Florida Tampa, Florida Associate Chief Neurology Department of Medicine, Division of Neurology Lehigh Valley Hospital Allentown, Pennsylvania Deepti Anbarasan, MD Resident Physician Department of Neurology and Psychiatry New York University New York University Langone Medical Center New York, New York Catalina Cleves Bayon, MD Assistant Professor Department of Neurology University of Pittsburgh Medical Center Children’s Hospital Pittsburgh, Pennsylvania Mark D Anderson, MD Resident Department of Neurology Vanderbilt University Vanderbilt University Medical Center Nashville, Tennessee Ronnie Bergen, MD Assistant Professor of Clinical Neurology University of Arizona College of Medicine Attending Neurologist Department of Neurology University Medical Center Tucson, Arizona Miriam Anixter, MD Assistant Professor Department of Anesthesia University of Pittsburgh Medical Center Attending Department of Anesthesia Children’s Hospital of Pittsburgh Pittsburgh, Pennsylvania Ryan Armour, DO Chief Resident Department of Neurology Cleveland Clinic Cleveland, Ohio W David Arnold, MD Assistant Professor Department of Neurology The Ohio State University Columbus, Ohio Ruth Ann Baird, MD Assistant Professor Department of Neurology Indiana University School of Medicine Indianapolis, Indiana David Q Beversdorf, MD Associate Professor William and Nancy Thompson Endowed Chair in Radiology Department of Radiology, Neurology, and Psychologic Sciences and the Thompson Center University of Missouri Columbia, Missouri Adarsh Bhimraj, MD Associate Staff Department of Infectious Diseases Section Head Department of Neurologic Infectious Diseases Cleveland Clinic Foundation Cleveland, Ohio Kevin M Birnie, MD, MS Neuroradiology Fellow Department of Radiology The Cleveland Clinic Cleveland, Ohio vii P1: OSO/OVY P2: OSO/OVY LWBK998-FM LWBK998-Lynn viii r r r QC: OSO/OVY T1: OSO January 28, 2012 11:45 Contributors List Eric C Bourekas, MD Associate Professor of Radiology, Neurology, and Neurological Surgery Department of Radiology The Ohio State University Columbus, Ohio Ritvij Bowry, MD Neurology Resident Department of Neurology New York University New York University Medical Center New York, New York Stacey G Boyer, MA Clinical Scientist Neuroscience Research Unit Pfizer Incorporated Groton, Connecticut Marla B Bruns, MD, PhD Resident Department of Neurology The Ohio State University Medical Center Columbus, Ohio Linda M Burns, DO Clinical Instructor Department of Internal Medicine The Ohio State University Rheumatology Instructor Department of Rheumatology The Ohio State University Medical Center Columbus, Ohio Matthew L Bush, MD Assistant Professor Otolaryngology, Neurotology and Cranial Base Surgery Department of Otolaryngology—Head and Neck Surgery The University of Kentucky Medical Center Lexington, Kentucky Richard Camicioli, MD Professor Department of Medicine (Neurology) University of Alberta Movement Disorders and Geriatric and Cognitive Neurology Glenrose Rehabilitation Hospital Edmonton, Alberta Stephen Campbell, MD Division of Neurosurgery Lehigh Valley Hospital and Health Network Allentown, Pennsylvania John E Castaldo, MD Professor Department of Neurology University of South Florida Lehigh Valley Health Network Chief/Timothy Breidegam Endowed Chair Department of Neurology Lehigh Valley Hospital Allentown, Pennsylvania Thomas C Chelimsky, MD Department of Neurology Case Western Reserve University University Hospitals Case Medical Center Cleveland, Ohio James C Cleland, MBChB, FRACP Consultant Neurologist Department of Neurology Auckland City Hospital Auckland, New Zealand Atif B.D Collins, MD Clinical Assistant Professor Department of Ophthalmology The Ohio State University Columbus, Ohio Aaron K Compton, MD Clinical Director Department of Pain Medicine Schneck Medical Center Seymour, Indiana Sheri Cotteman-Hart, MD, PhD Assistant Professor Department of Neurology The Ohio State University Columbus, Ohio John A Davis, PhD, MD Assistant Professor Department of Medicine Ohio State University Assistant Clinical Director Division of Infectious Diseases Ohio State University Medical Center Columbus, Ohio Gabrielle Deveber, MD Director, Children’s Stroke Program Hospital for Sick Children University of Toronto Toronto, Ontario Jorina Elbers, MD Pediatric Stroke Fellow Division of Neurology Department of Pediatrics University of Toronto Hospital for Sick Children Toronto, Ontario Lawrence W Elmer, MD, PhD Professor, Department of Neurology Director, Parkinson’s Disease and Movement Disorders Program Medical Director, Center for Neurological Health College of Medicine, University of Toledo Toledo, Ohio Bakri H Elsheikh, MBBS, FRCP Assistant Professor Department of Neurology The Ohio State University Attending Department of Neurology The Ohio State University Medical Center Columbus, Ohio Chad W Farley, MD Resident Physician Department of Neurosurgery University of Cincinnati Cincinnati, Ohio Kimberly Farrell, BS MD Candidate 2015 New York Medical College Valhalla, New York Magali J Fernandez, MD Private Practice Tampa, Florida David H Garabrant, MD Emeritus Professor of Occupational Medicine Environmental Health Sciences University of Michigan Internal Medicine University of Michigan Medical Center Ann Arbor, Michigan James M Gebel, MD Associate Professor Department of Neurology Cleveland Clinic Lerner College of Medicine Head of Enterprise Stroke System Operations Department of Neurology Cleveland Clinic Cleveland, Ohio Barbara S Giesser, MD Clinical Professor of Neurology Department of Neurology David Geffen UCLA School of Medicine Los Angeles, California P1: OSO/OVY P2: OSO/OVY LWBK998-FM LWBK998-Lynn QC: OSO/OVY T1: OSO February 13, 2012 7:10 Contributors List Elakkat Dharmaraj Gireesh, MD Resident Department of Neurology New York University New York, New York Joao A Gomes, MD Staff Neurointensivist Cerebrovascular Center The Cleveland Clinic Cleveland, Ohio Julian J Goodman, MD Fellow Division of Infectious Diseases Department of Internal Medicine The Ohio State University The Ohio State University Medical Center Columbus, Ohio Kevin V Hackshaw, MD Associate Professor of Medicine Fellowship Director Rheumatology Internal Medicine The Ohio State University Columbus, Ohio Christina M Hadzitheodorou, BA Columbia University New York, New York C.L Hall, MD Fellow Division of Neuroscience Critical Care Department of Neurosurgery and Neurology Emory University School of Medicine Atlanta, Georgia Charles W Hall Jr., MD, PhD Robert A Hauser, MD, MBA Professor Department of Neurology University of South Florida Tampa, Florida Donald S Higgins Jr., MD Professor Department of Neurology Albany Medical College Chief of Neurology Service Samuel S Stratton VA Medical Center Albany, New York J Chad Hoyle, MD Assistant Professor of Neurology Department of Neurology Ohio State University Columbus, Ohio Gary Hsich, MD Residency Program Director Center for Pediatric Neurology Cleveland Clinic Cleveland, Ohio Carlos Isada, MD Department of Infectious Disease Cleveland Clinic Main Campus Cleveland, Ohio H.A Jinnah, MD, PhD Professor Departments of Neurology Human Genetics, and Pediatrics Emory University Emory University Hospital Atlanta Georgia Stephen Jones, MD, PhD Assistant Professor Radiology Department of Radiology Cleveland Clinic Lerner College of Medicine Staff Neuroradiologist Imaging Institute Cleveland Clinic Cleveland, Ohio S Anne Joseph, MD Associate Professor/Program Director Department of Neurology Division of Child Neurology Residency Program Medical College of Wisconsin Interim Section Chief Department of Neurology Division of Pediatric Neurology Children’s Hospital of Wisconsin Milwaukee, Wisconsin Vern C Juel, MD Associate Professor of Medicine (Neurology) Division of Neurology Duke University School of Medicine Durham, North Carolina David P Kasick, MD Assistant Professor of Clinical Psychiatry Department of Psychiatry The Ohio State University School of Medicine Columbus, Ohio r r r ix Steven E Katz, MD Associate Professor Department of Ophthalmology Terrance A Makely Research Professor in Ophthalmology Director, Division of Neuro-ophthalmology Department of Ophthalmology, Orbital Disease and Oculoplastics Ohio State University Columbus, Ohio Irene L Katzan, MD Director Center for Outcomes Research and Evaluation Neurological Institute Cleveland Clinic Cleveland, Ohio Nancy E Kelley, MD, PhD Director, Headache Center Department of Neurology Geisinger Medical Center Dansville, Pennsylvania Meena Khan, MD Assistant Professor Department of Neurology/Internal Medicine The Ohio State University Columbus, Ohio Sara Khan, MD Fellow Neuromuscular Center Cleveland Clinic Cleveland, Ohio Andrew Kirk, MD Professor and Head Department of Neurology University of Saskatchewan Royal University Hospital Saskatoon, Saskatchewan Yasushi Y Kisanuki, MD Assistant Professor Department of Neurology Division of Neurogenetics The Ohio State University Medical Center Columbus, Ohio John T Kissel, MD Professor of Neurology and Pediatrics Department of Neurology The Ohio State University Director, Division of Neuromuscular Medicine Department of Neurology The Ohio State University Hospital Columbus, Ohio P1: OSO/OVY P2: OSO/OVY LWBK998-FM LWBK998-Lynn x r r r QC: OSO/OVY T1: OSO January 28, 2012 11:45 Contributors List GurSimran Singh Kochhar, MD Resident Internal Medicine Cleveland Clinic Foundation Cleveland, Ohio Boyd M Koffman, MD, PhD Associate Professor Department of Neurology University of Toledo Staff Neurologist Department of Neurology University of Toledo Medical Center Toledo, Ohio Susan L Koletar, MD Professor Department of Medicine/Infectious Diseases The Ohio State University Columbus, Ohio Jennifer S Kriegler, MD Associate Professor Department of Medicine (Neurology) The Cleveland Clinic Lerner College of Medicine of Case Western Reserve University Staff Neurological Institute The Cleveland Clinic Cleveland, Ohio Roger Kurlan, MD Director, Movement Disorders Program Atlantic Neuroscience Institute Overlook Hospital Summit, New Jersey Jaclyn Laine, DO Clinical Neurophysiology Fellow Vanderbilt University Nashville, Tennessee Victoria Lawson, MD Assistant Professor Department of Neurology The Ohio State University Columbus, Ohio Beth A Leeman, MD, MA, MSc Assistant Professor Department of Neurology Emory University Director, Epilepsy Unit Atlanta VA Medical Center Atlanta, Georgia Robert E Leininger, MD Fellow in Infectious Diseases Department of Internal Medicine Ohio State University Ohio State University Medical Center Columbus, Ohio Kerry H Levin, MD Professor of Medicine (Urology) Cleveland Clinic Lerner College of Medicine Chairman Department of Neurology Cleveland Clinic Cleveland, Ohio P Mark Li, MD, PhD Chief, Neurological Surgery Department of Surgery Division of Neurosurgery Lehigh Valley Hospital and Health Network Allentown, Pennsylvania Hongyan Li, MD, PhD Assistant Professor Department of Neurology University of Toledo Medical Center Director Vestibular and Dizziness Program Faculty, Comprehensive Epilepsy Center Department of Neurology The University Hospital Toledo, Ohio Yuebing Li, MD, PhD Attending Neurologist Associate Director of the Lehigh Valley Neuromuscular Center Department of Medicine Lehigh Valley Health Network Allentown, Pennsylvania Mei Lu, MD, PhD Full Staff Cerebrovascular Center, Neuromuscular Division Neurological Institute Cleveland Clinic Foundation Cleveland, Ohio D Joanne Lynn, MD Associate Dean for Student Life Clinical Professor of Neurology Ohio State University College of Medicine Columbus, Ohio Glenn A Mackin, MD Associate Professor of Clinical Neurology Department of Neurology Penn State/Milton S Hershey Memorial Center Hershey, Pennsylvania Director, Neuromuscular Disease Center ALS Multidisciplinary Clinic Department of Medicine Division of Neurology Lehigh Valley Hospital Allentown, Pennsylvania Lavina Malhotra, MD Surgical Resident Department of Surgery The Ohio State University Medical Center Columbus, Ohio Andrea G Malone, DO Clinical Instructor House Staff Department of Neurology The Ohio State University Movement Disorders Fellow Department of Neurology The Ohio State University Medical Center Columbus, Ohio Jacob J Mandel, MD Resident Department of Neurology Ohio State Medical Center Ohio State University Columbus, Ohio Julie E Mangino, MD Professor Department of Internal Medicine Medical Director Department of Clinical Epidemiology The Ohio State University Columbus, Ohio Nicholas F Marko, MD AANS Van Wagenen Fellow Computational Biology Cambridge Cancer Institute Department of Applied Mathematics and Theoretical Physics Cambridge University Cambridge, United Kingdom Stanley I Martin, MD Assistant Professor of Clinical Internal Medicine Transplant Infectious Diseases Service Division of Infectious Diseases The Ohio State University Medical Center Columbus, Ohio Shavonne L Massey, MD Resident Physician Department of Child Neurology New York University School of Medicine New York University Medical Center New York, New York Patrick J McDonald, MD Associate Professor Section of Neurosurgery University of Manitoba Director Pediatric Neurosurgery Winnipeg Children’s Hospital Winnipeg, Manitoba ... Cataloging-in-Publication Data The 5- minute neurology consult / [edited by] D Joanne Lynn, Herbert B Newton, Alexander D Rae-Grant – 2nd ed p ; cm Five -minute neurology consult Includes bibliographical... OSO/OVY T1: OSO January 28, 2012 11: 45 ii P1: OSO/OVY P2: OSO/OVY LWBK998-FM LWBK998-Lynn QC: OSO/OVY April 4, 2012 T1: OSO 14:48 The 5- Minute Neurology Consult 2ND EDITION Editors D Joanne Lynn,... edition of the Neurology volume to the 5- Minute Consult series This book is intended to present current clinical information to several groups: r Busy clinical practitioners in neurology general