LF:VLNE9X1c Neurology - practice

VLNE9X1c Neurology - practice

Faculty of Medicine
autumn 2024

Extent and Intensity

0/6/0. 3 credit(s). Type of Completion: z (credit).
Taught in person.

Teacher(s)

Guaranteed by

doc. MUDr. Eva Vlčková, Ph.D.
Department of Neurology – Joint workplaces with the University Hospital Brno - workplaces of the Bohunice and Mater. Hospital – Faculty of Medicine
Supplier department: First Department of Neurology – Institutions shared with St. Anne's Faculty Hospital – Faculty of Medicine (40,00 %), Department of Neurology – Joint workplaces with the University Hospital Brno - workplaces of the Bohunice and Mater. Hospital – Faculty of Medicine (40,00 %), Department of Pediatric Neurology – Institutions shared with the Faculty Hospital Brno (paediatric medicine) – Faculty of Medicine (20,00 %)

Prerequisites

( VLFA08222c Pharmacology II || VLFA0722p Pharmacology - L ) && ( VLDI7X1c Diagn.imaging - practice || VLDM7X1c Diagn. imamaging -practice ) && VLOL7X1c Ophthalmology - practice && VLCH0832c Surgery II - practicals
Prior to the start of each course, pre-reading is required and is available in the interactive syllabus (in the Neurology lecture).
Prior to the SIMU teaching blocks, it is recommended to watch the following pre-learning presentations (if they have not already been part of the workshops on the previous teaching days):
Day 1: Cerebrovascular disease
Day 2: Cognitive Disorders, Neuromuscular Diseases, Multiple Sclerosis, Spine and Spinal Cord Diseases
Day 3: Spine and Spinal Cord Diseases

Course Enrolment Limitations

The course is only offered to the students of the study fields the course is directly associated with.

fields of study / plans the course is directly associated with

General Medicine (programme LF, M-VL) (2)

Course objectives

The aim of the course is to provide a basic knowledge of:
- The basic principles of the clinical neurological examination
- The main neurological symptoms and syndromes
- Current neurological diagnosis and differential diagnosis in the main neurological diagnostic units;
- Indication of the most commonly used diagnostic tests (imaging, laboratory, electrophysiology, etc.) in neurological patients and interpretation of their main results.

Learning outcomes

By the end of the course, students should be able to:
- Understand and explain the fundamentals and principles of neurology;
- Work with information from the history and neurological examination to identify symptoms/signs and syndromes of neurological disorders;
- Make reasoned decisions about the current diagnosis and differential diagnosis based on symptomatology;
- Make deductions on the basis of acquired knowledge in the field of neurology;
- Identify and interpret basic imaging, laboratory and electrophysiological tests used in neurological patients.

Syllabus

General neurology Neurological syndromology and neurological evaluation. The practical lectures in the lecture hall and bedside examination of the patients.
MAIN TOPICS: 1. neurological history taking. Reflexology. Palsies, pyramidal signs.
2. Cranial nerves examination. Sensitivity and its affections.
3. Extrapyramidal and cerebellar signs. Spine examination. Disorders of the stance and walking. Meningeal syndrome. Uncousciousness.
4. aphasias, alexia, agraphia and other higher central nervous system disorders
5. neurological paraclinical examinations, Neurological examination and notes. Neurological diagnosis.
6-7. Pediatric neurology, the principles of examination of pediatric patients. Focus on main nosological units and syndromes in child neurology.
8. stroke, multiple sclerosis.
9. Epilepsy, tumors, vertebrogenic disorders, movement disorders, headache, dementias.
10. Neuromuscular disorders, mono- and polyneuropathies, AIDP, CIDP, critical illness patient.
Classified credit (practical exam with written neurological examation of the patient).

Literature

required literature

ŠPINAR, Jindřich and Ondřej LUDKA. Propedeutika a vyšetřovací metody vnitřních nemocí. 2., přeprac. a dopl. vyd. Praha: Grada, 2013, 336 s. ISBN 9788024743561. info
ŠTOURAČ, Pavel, Josef BEDNAŘÍK, Milan BRÁZDIL, Zdeněk KADAŇKA, Petr KAŇOVSKÝ, Marek MECHL, Jiří PRÁŠEK, Ivan REKTOR, Irena REKTOROVÁ and Radomír ŠLAPAL. Učebnice obecné neurologie (Textbook of General Neurology). 2., přepracované. Brno: Masarykova universita v Brně, 2003, 197 pp. ISBN 80-210-3309-6. info
Učebnice speciální neurologie. Edited by Zdeněk Kadaňka. 3., přeprac. vyd. Brno: Masarykova univerzita, 2010, 302 s. ISBN 9788021053205. info

recommended literature

RŮŽIČKA, Evžen, Karel ŠONKA, Petr MARUSIČ and Robert RUSINA. Neurologie. 1. vydání. Praha: Stanislav Juhaňák - Triton, 2019, xxxix, 541. ISBN 9788075536815. info
Učebnice speciální dětské neurologie : pro studenty 4. a 5. ročníku LF MU s rozšířenou výukou pediatrie (Special Pediatric Neurology for students of the 4th and 5th years, Medical Faculty, Masaryk University, with extended education in pediatrics). Edited by Hana Ošlejšková. 1. vyd. Brno: Masarykova univerzita, 2011, 123 s. ISBN 9788021056596. info
AULICKÁ, Štefánia, Hana OŠLEJŠKOVÁ, Katarína ČESKÁ, Michaela HABALOVÁ, Klára ŠPANĚLOVÁ and Petra HANÁKOVÁ. Základy vývojové neurologie (Principles of developmental neurology). 1st ed. Brno: Masarykova univerzita, 2020. ISBN 978-80-210-9621-9. info
Merritt’s Neurology, 13th Edition is edited by by Elan D. Louis MD MS (Author), Stephan A. Mayer MD (Author), Lewis P. Rowland MD (Author) ISBN-13: 978-1451193367, ISBN-10: 145119336X
International Neurology: A clinical approach: by Robert P. LIsak, Daniel D Truong, William M Carroll, Roongroj Bhidayasiri, Blackwell Publishing Ltd 2010, ISBN 9781444317008
John Morris, Joseph Jankovic: Neurological Clinical Examination, Hodler Arnold Co, 2012

Teaching methods

- Practical and clinical teaching is carried out in a contact form in the teaching hospitals and in the Simulation Centre (SIMU). The student directly participates in the inpatient wards (including the ict centre and neurological intensive care) and in outpatient clinics or specialised examination rooms (EEG, EMG, EP, sono). As part of the internship, the student gains practical experience with basic neurological nosological units and syndromes. Under the supervision of the teachers, he/she learns to examine neurological patients, to form syndromological, topical and then etiopathogenetic diagnosis, to form differential-diagnostic balance, to propose paraclinical examinations and to discuss with the teachers therapeutic options for the relevant nosological unit.
A few days of hands-on training will be in the form of simulation training (conducted at the MUNI Simulation Center) on simulators with varying degrees of fidelity. Specifically, these are:
- SBL simulations
- skills training, i.e. training in lumbar puncture performance
- TBL simulations
- The simulation results in a debriefing (feedback to the student). Learning is both problem-based (the student learns by solving the problem presented) and team-based (when small groups of students discuss and choose a solution to the problem). Emphasis is also placed on the development of soft skills, including so-called "21st century skills", in particular communication, decision-making, critical thinking, crisis communication and teamwork.
The seminar part of the training takes the form of workshops with specialists in the relevant field (the workshop emphasizes the most important information on the given issue, new developments in the field, usually in combination with (video) case studies). This teaching is carried out in the form of contact, or in case of a serious deterioration of the current epidemiological situation in the form of synchronous online teaching via MS Teams. The specific timetable for the respective teaching session will be available on the bulletin board of the respective clinic or online in the Study Materials section and the folder of the respective clinic where the student carries out the predominant part of the internship.

Assessment methods

- PRE-TESTS (available in the Interactive Syllabus of Neurology - Lecture). Before starting their practical training, students must complete the General Neurology lectures (and take the tests available at the end of each lecture). Pre-lectures focused on specific topics of Specialised Neurology (Epileptology, Neuromuscular Medicine, Stroke, etc.) must be completed before starting the clinical lecture focused on that topic.
ADMISSION TEST in Neuroanatomy and Neurophysiology (to be given on the 21st or 2nd day of the course). This will be a test of pre-clinical knowledge of the anatomy and physiology of the nervous system.
- Intermediate assessment of clinical skills and knowledge of neurological propaedeutic, clinical neurological assessment, paraclinical diagnostic methods in neurology and the ability to make syndrological, topical and differential diagnoses - the teacher provides objective, specific and targeted feedback to each student. - During the last week of the course (usually on Wednesday or Friday, i.e. on the 13th or 15th day of the course), there is an intermediate written test on Neurological Propedeutics, Clinical Neurological Assessment, Paraclinical Diagnostic Methods in Neurology.
- CLASSIFIED CREDIT (practical examination as an integral part of the Final Exam in Neurology) - during the last day of the course, consisting of
1. Clinical examination of the patient (including medical history), syndromological diagnosis, local diagnosis and differential diagnosis;
2. An oral practical examination with emphasis on neurological pre-requisites, clinical neurological examination and the indication and interpretation of basic paraclinical tests neurological patients.
- FINAL ORAL EXAM: one question on general neurology, two questions on special neurology.

Language of instruction

Czech

Further comments (probably available only in Czech)

The course is taught each semester.
The course is taught: in blocks.
Information on the extent and intensity of the course: 90.

Teacher's information

The course takes place in one of the following neurological clinics according to the timetable:

- Neurological Clinic of the University Hospital in Brno (FN Brno)

- 1st Clinic of Neurology, St. Anne's University Hospital (FN USA)

- Paediatric Neurology Clinic (FDN)

The course starts every day at 8 am and ends at 1 pm. At the beginning of the first day of the course, students report to the secretariat of the respective department:

- NK FN Brno, Jihlavská 20, 12th floor of the main building (L), Mrs. Saláková (53223 2503)

- NK FN USA, Pekařská 53, building C1, 6th floor, Mrs Aberlová (54318 2658)

- KDN, Černopolní 9, building G, 4th floor, Mrs Chalupová (53223 4919)

Students should bring their own white coats and neurological hammers. Neurological hammers are available in the medical bookshop in building A9, Bohunice campus (Kamenice 753/5, tel. 54949 3619). Students attending courses at NK FN Brno can borrow a hammer from the secretary's office against a signature.

The course requires basic knowledge of neuroanatomy and neurophysiology (motor pathway: pyramidal tracts, cerebellum, basal ganglia, sensory pathway, thalamus, visual pathway, cranial nerves, neurotransmitters). Before the start of each course, the pre-study material available in the interactive syllabus (in the Neurology lecture) should be viewed.

Pre-clinical knowledge of the anatomy and physiology of the nervous system will be tested later in the admission test, which will be taken under the supervision of the teacher no later than the second day of the course. A minimum of 80% correct answers is required to pass the test. Students who fail the admission test will have the opportunity to repeat it on the last day of the course (just before the practical exam in neurology).

During the first two days of the course, an introduction to neurological principles and the neurological examination is given and practised. Knowledge of clinical neurological examination and propedeutics will be tested by short oral exams during the second half of the course and by the written intermediate exam on neurological propedeutics, clinical neurological assessment, paraclinical diagnostic methods in neurology during the last week of the course (usually on Wednesday or Friday, i.e. 13th or 15th day of the course).

The other days of the course consist of a clinical part (provided by both the in-patient and out-patient parts of the Neurology Department and special laboratories, i.e. Ultrasound and Clinical Neurophysiology - EMG, EEG, Evoked Potentials, or by SIMU) and focused workshops with specialists in particular areas of neurology.

Students completing their training in one of the adult neurology departments spend two days of the course in the paediatric neurology department (Children's Hospital, Černopolní 9, building G, 4th floor) to learn the basics of paediatric neurology (developmental neurology, neurodevelopmental disorders, cerebral palsy, neuromuscular disorders in childhood, paediatric epileptology). Students who complete their training in the paediatric neurology department spend two days of the course in one of the departments that provide neurological care for adult patients (Department of Neurology, FN Brno or FN USA) in order to learn the basics of adult neurology (stroke, neurodegenerative diseases, diseases of the spine and spinal cord). We strongly recommend that students replace one of their morning lectures with an afternoon lecture (e.g. from 11:00 to 16:00 - i.e. including the morning workshop) or alternatively attend an evening/night duty (based on an individual agreement with the teacher responsible for the particular course). In order to achieve the maximum practical effect of such a substitution, it is preferable to carry it out during the second or third week of the course.

On the last (15th) day of the course, the students will take the PRACTICAL EXAM (for credit), which is an integral part of the final exam in Neurology and consists of

a. Clinical examination of the patient (including history), syndromological, topical and differential diagnosis;

b. Oral examination focusing on the clinical neurological examination, neurological propedeutics and the indication and interpretation of basic paraclinical examinations used in neurological patients.

WE WISH TO REMIND STUDENTS THAT THE TIMETABLE OF THE COURSE CAN'T BE CHANGED (except for very serious reasons - stay abroad, long-term illness).

More detailed information (including the timetable of your course) can be found on the notice boards in the secretariats of each department. You can also contact the deputy head of the department for further information:

- In FN Brno: Associate Professor Eva Vlčková, MD, PhD (vlckova.eva@fnbrno.cz)

- In FN USA: Associate Professor Martin Pail, MD, PhD (martin.pail@fnusa.cz)

- In FDN: Associate Professor Hana Ošlejšková, MD, PhD (oslejskova.hana@fnbrno.cz)

The course is also listed under the following terms Spring 2000, Autumn 2000, Spring 2001, Autumn 2001, Spring 2002, Autumn 2002, Spring 2003, Autumn 2003, Spring 2004, Autumn 2004, Spring 2005, Autumn 2005, Spring 2006, Autumn 2006, Spring 2007, Autumn 2007, Spring 2008, Autumn 2008, Spring 2009, Autumn 2009, Spring 2010, Autumn 2010, Spring 2011, Autumn 2011, Spring 2012, Autumn 2012, Spring 2013, Autumn 2013, Spring 2014, Autumn 2014, Spring 2015, Autumn 2015, Spring 2016, Autumn 2016, Spring 2017, Autumn 2017, Spring 2018, autumn 2018, spring 2019, autumn 2019, spring 2020, autumn 2020, spring 2021, autumn 2021, spring 2022, autumn 2022, spring 2023, autumn 2023, spring 2024, spring 2025.

Enrolment Statistics (autumn 2024, recent)
Permalink: https://is.muni.cz/course/med/autumn2024/VLNE9X1c

LF:VLNE9X1c Neurology - practice - Course Information

VLNE9X1c Neurology - practice

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