362 Ch 361. Approach to the Patient with Neurologic Disease

Neurologic diagnosis = anatomic localization (where is the lesion?) + etiologic diagnosis (what is the cause?)；history (most important) + neurological examination + localized investigations；neuroaxis localization: cortex (cognition, language, sensory, motor) → subcortical white matter → basal ganglia (movement) → brainstem (cranial nerves, long tracts, consciousness) → cerebellum (coordination, gait) → spinal cord (level, tracts) → root → plexus → peripheral nerve → NMJ → muscle；neuroimaging: CT (acute hemorrhage, trauma, bone) vs MRI (definitive — most pathology) with DWI (acute stroke), FLAIR (lesions), T2*/SWI (microbleeds), gadolinium (enhancement)；EEG for seizures, encephalopathy；LP/CSF for infection, inflammation, malignancy, ICP；EMG/NCS for neuropathy, NMJ, myopathy；genetic testing for hereditary。