GEM - Curriculum statement 15.7 neurological problems

Knowledge Base for the nMRCGP

Curriculum Statement 15.7 Neurological Problems

Symptoms:

• Headache
  • headache section on GPnotebook
• Vertigo/dizziness (neurological, otological, psychological and cardiovascular causes)
  • vertigo section on GPnotebook
• Tremor
  • tremor section on GPnotebook
• Neuropathies
  • neuropathies section on GPnotebook
• Abnormal movements/chorea
  • abnormal movements section on GPnotebook
• Seizures
  • seizures section on GPnotebook
• Drowsiness
• Loss of consciousness and coma
  • loss of consciousness section on GPnotebook
  • coma section on GPnotebook

Common and/or important conditions:

• Epilepsy
  • epilepsy section on GPnotebook
• Common causes of headache – tension headache, migraine, cluster headache, cervical neuralgia, sinusitis, dental pain, drug rebound headache
  • tension headache section on GPnotebook
  • migraine section on GPnotebook
  • cluster headache section on GPnotebook
  • sinusitis section on GPnotebook
• Important causes of headache – raised intracranial pressure, thunderclap headache (subarachnoid haemorrhage, enlarging aneurism or migraine), temporal arteritis, trigeminal neuralgia, herpes zoster, cancers
  • raised intracranial pressure section on GPnotebook
  • thunderclap headache on GPnotebook
  • sudden onset headache
  • temporal arteritis section on GPnotebook
  • trigeminal neuralgia section on GPnotebook
  • herpes zoster section on GPnotebook
  • brain tumours section on GPnotebook
• Brain infections – meningitis, encephalitis, brain abscess, tuberculosis, HIV
  • meningitis section on GPnotebook
  • encephalitis section on GPnotebook
  • brain abscess section on GPnotebook
  • tuberculosis section on GPnotebook
  • HIV section on GPnotebook
• Neurological causes of vertigo – stroke (brainstem and cerebellar haemorrhage/infarction), multiple sclerosis, trauma and concussion, acoustic neuroma, brain tumours
  • stroke section on GPnotebook
  • multiple sclerosis section on GPnotebook
  • acoustic neuroma section on GPnotebook
  • brain tumours section on GPnotebook
• Mononeuropathies – trigeminal neuralgia, Bell’s palsy, carpal tunnel syndrome, nerve entrapments, e.g. ulnar, sciatic and femoral nerves
  • trigeminal neuralgia section on GPnotebook
  • Bell's palsy section on GPnotebook
  • carpal tunnel syndrome section on GPnotebook
  • mononeuropathies section on GPnotebook
• Polyneuropathies – metabolic causes (diabetes, alcohol, vitamin B12 and folate, porphyria, uraemia, infectious causes (e.g. Guillain-Barré, post viral, HIV), drugs induced neuropathy
  • polyneuropathies section on GPnotebook
  • drug-induced polyneuropathies on GPnotebook
• Multiple sclerosis
  • multiple sclerosis section on GPnotebook
• Amyotrophic lateral sclerosis
  • amyotrophic lateral sclerosis section on GPnotebook
• Essential tremor
  • essential tremor section on GPnotebook
• Parkinson’s disease
  • Parkinson's disease section on GPnotebook
• Congenital conditions, e.g. cerebral palsy, spina bifida
  • cerebral palsy section on GPnotebook
  • spina bifida section on GPnotebook
• Genetic conditions, e.g. Huntingdon’s disease.
  • Huntingdon's disease section on GPnotebook

Investigation:

• Knowledge of secondary care investigations and treatment including: electroencephalography (EEG), computerised tomography (CT) and magnetic resonance imaging (MRI), nerve conduction studies.
  • EEG section on GPnotebook
  • CT section on GPnotebook
  • MRI section on GPnotebook

Treatment:

• Understand principles of treatment for common conditions managed largely in primary care – epilepsy, headaches, vertigo, neuropathic pain, mononeuropathies, essential tremor and Parkinson’s disease
  • Parkinson's disease section on GPnotebook
  • epilepsy section on GPnotebook
  • essential tremor section on GPnotebook
  • mononeuropathies section on GPnotebook
  • neuropathic pain section on GPnotebook

Emergency care:

• Acute management of meningitis and meningococcal septicaemia
  • meningitis section on GPnotebook
• Acute management of people presenting with collapse, loss of consciousness or coma
• Understand indications for emergency referral of people with stroke, intra-cranial haemorrhage, raised intracranial pressure and temporal arteritis
  • stroke section on GPnotebook
  • temporal arteritis section on GPnotebook

Prevention:

• Health education and accident prevention advice for people with epilepsy
• Vaccination for meningococcal disease
• Understand avoidance of triggers and prophylaxis for migraine
• Investigation of people with family history of genetic neurological disease, e.g. Berry aneurysm.

Related GPnotebook Educational Modules (GEMs):

• epilepsy GEM
• Parkinson's Disease GEM