LF:aVLNE9X1c Neurology - practice

aVLNE9X1c Neurology - practice

Faculty of Medicine
spring 2023

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 %)

Timetable of Seminar Groups

aVLNE9X1c/30: Mon 13. 2. 8:00–13:00 NeurolK N12190, Tue 14. 2. 8:00–13:00 NeurolK N12190, Wed 15. 2. 8:00–13:00 NeurolK N12190, Thu 16. 2. 8:00–13:00 NeurolK N12190, Fri 17. 2. 8:00–13:00 NeurolK N12190, Mon 20. 2. 8:00–13:00 KDIN N01001, Tue 21. 2. 8:00–13:00 KDIN N01001, Wed 22. 2. 8:00–13:00 F37/114, 8:00–13:00 F37/111, 8:00–13:00 F37/115, Thu 23. 2. 8:00–13:00 F37/329, 8:00–13:00 F37/358, Fri 24. 2. 8:00–13:00 F37/366, Mon 27. 2. 8:00–13:00 NeurolK N12190, Tue 28. 2. 8:00–13:00 NeurolK N12190, Wed 1. 3. 8:00–13:00 NeurolK N12190, Thu 2. 3. 8:00–13:00 NeurolK N12190, Fri 3. 3. 8:00–13:00 NeurolK N12190
aVLNE9X1c/31: Mon 22. 5. 8:00–13:00 I.NK N05022, Tue 23. 5. 8:00–13:00 I.NK N05022, Wed 24. 5. 8:00–13:00 I.NK N05022, Thu 25. 5. 8:00–13:00 I.NK N05022, Fri 26. 5. 8:00–13:00 I.NK N05022, Mon 29. 5. 8:00–13:00 KDN N04085, Tue 30. 5. 8:00–13:00 KDN N04085, Wed 31. 5. 8:00–13:00 F37/115, 8:00–13:00 F37/114, 8:00–13:00 F37/111, 8:00–13:00 F37/327, Thu 1. 6. 8:00–13:00 F37/327, 8:00–13:00 F37/358, Fri 2. 6. 8:00–13:00 F37/366, Mon 5. 6. 8:00–13:00 I.NK N05022, Tue 6. 6. 8:00–13:00 I.NK N05022, Wed 7. 6. 8:00–13:00 I.NK N05022, Thu 8. 6. 8:00–13:00 I.NK N05022, Fri 9. 6. 8:00–13:00 I.NK N05022
aVLNE9X1c/34: Mon 20. 2. 8:00–13:00 I.NK N05022, Tue 21. 2. 8:00–13:00 I.NK N05022, Wed 22. 2. 8:00–13:00 I.NK N05022, Thu 23. 2. 8:00–13:00 I.NK N05022, Fri 24. 2. 8:00–13:00 I.NK N05022, Mon 27. 2. 8:00–13:00 KDIN N01001, Tue 28. 2. 8:00–13:00 KDIN N01001, Wed 1. 3. 8:00–13:00 F37/111, 8:00–13:00 F37/114, 8:00–13:00 F37/115, 8:00–13:00 F37/327, Thu 2. 3. 8:00–13:00 F37/327, 8:00–13:00 F37/358, Fri 3. 3. 8:00–13:00 F37/366, Mon 6. 3. 8:00–13:00 I.NK N05022, Tue 7. 3. 8:00–13:00 I.NK N05022, Wed 8. 3. 8:00–13:00 I.NK N05022, Thu 9. 3. 8:00–13:00 I.NK N05022, Fri 10. 3. 8:00–13:00 I.NK N05022

Prerequisites

aVLFA0822c Pharmacology II -pr. && aVLCH0832c Surgery II - practice && aVLOL7X1c Ophthalmology - practice && aVLDI7X1c Diagn.imaging methods- pr.
Starting from the spring semester of 2022, pre-learning available in the interactive syllabus (in Neurology-lecture) is required before the beginnig of each course. Before the very start of their practice, students are required to go through the presentations focused on general neurology (and to pass the tests available at the end of each lecture). Prelearning focused on particular topics of special neurology (epileptology, neuromuscular medicine, stroke and so on) has to be completed before the beginnig of the clinical lecture focused on appropriate topic.

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-GM)
General Medicine (eng.) (programme LF, M-VL)

Course objectives

The aim of the course is to provide the basic knowledge about:
- key principles of clinical neurological examination;
- the most important neurological symptoms and syndromes;
- topical diagnosis in neurology;
- clinical picture, and the differential diagnosis of the most important neurological diagnostic units;
- medical management of acute stroke patients;
- the most frequently used electrophysiological, imaging, and laboratory diagnostic tests in neurology including their indication and the interpretation of their most important results.

Learning outcomes

At the end of the course, the students should be able to:
- understand and explain the basic principles of neurology;
- work with information on the medical history and neurological examination to establish the symptoms and to derive syndromes of the neurological disorders;
- make reasoned decisions about the topical diagnosis and differential diagnosis based on the symptomatology;
- make deductions based on acquired knowledge in the field of neurology;
- indicate and interpret basic the most frequently used electrophysiological, imaging, and laboratory diagnostic methods in neurological patients.

Syllabus

Clinical neurological examination, neurological propaedeutic, semiology, and syndromology. In particular, the following topics will be addressed:
- taking neurological history;
- reflexology, palsies, pyramidal signs;
- examination of the cranial nerves;
- sensory examination;
- extrapyramidal and cerebellar signs;
- examination of the spine and spinal cord;
- disorders of the stance and walking;
- meningeal syndrome, intracranial hypo-, and hypertension;
- unconsciousness;
- developmental neurology, neurological examination of pediatric patients.
Practical experience with neurological patients in both in- and outpatient parts of the clinics including the intensive care unit, stroke unit, neurophysiological labs, and clinical wards (both in adult and children´s parts of the hospital). Among others, this includes:
- ward round participation;
- participation in clinical neurological examinations performed by trained neurologists followed by the discussion in the interpretation of particular diagnostic tests and overall clinical status of the patient and suggestion of further diagnostic and treatment options (at least 10 patients)
- clinical neurological examination of particular patients performed by students and followed by an instant debriefing with the teacher aimed at the clinical status of the patients, interpretation of particular clinical findings, syndromology, and topical diagnosis, the suggestion of further diagnostic tests and discussion on treatment options (in total, each student will examine at least 5 patients with different diagnostic units, including at least one stroke patient).
Practical experience with the most important and most frequently used diagnostic methods in neurology:
- electroencephalography;
- nerve conduction studies and electromyography;
- evoked potentials;
- ultrasound examination (carotid + transcranial);
- other imaging methods including interpretation of the results (MRI, CT, angiography) (within the frame of ward rounds, case report discussions, and simulation lecture focused on stroke - see below);
- lumbar puncture and cerebrospinal fluid examination (among others within the frame of simulation lecture - see below).
Simulation lectures:
- medical management of acute stroke patients (SBL simulation) (if needed, the lecture can be substituted by direct experience with the management of acute stroke in an intensive care unit or stroke unit);
- lumbar puncture and the cerebrospinal fluid examination (skills training) (if needed, the lecture can be substituted by direct experience with lumbar puncture procedure in an in- or outpatient part of the clinics);
- headache (TBL simulation) (if needed, the lecture can be substituted by clinical experience with patients suffering from both primary and secondary headaches in an in- or outpatient part of the clinics).

Literature

required literature

VIVEKANANDA, Umesh. Crash Course Neurology. Edited by Philip Xiu - Shreelata Datta. 5th edition. [Edinburgh?]: Elsevier, 2019. xi, 278. ISBN 9780702073854.

recommended literature

Greenberg DA, Aminoff MJ, Simon RP. Lange Clinical Neurology, 11th Edition. McGraw Hill, 2020. xiii, 464. ISBN-10: 1260458350, ISBN-13: ‎978-1260458350
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
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
ŠPINAR, Jindřich and Ondřej LUDKA. Propedeutika a vyšetřovací metody vnitřních nemocí. 2., přeprac. a dopl. vyd. Praha: Grada, 2013, 336 s. ISBN 9788024743561. 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

Teaching methods

Initial workshops focused on particular steps in the clinical neurological examination followed by practical lectures provided by both the inpatient and outpatient parts of the neurological department (including the neurological intensive care unit and stroke unit) and special labs (ultrasonography, clinical neurophysiology, i.e. NCS + EMG, EEG, evoked potentials). The concept of learning is problem-oriented (students are taught by solving the problem presented) and team-oriented (small groups of students discuss and choose a solution to the problem). Special emphasis is laid on the development of soft skills, incl. so-called "21st-century skills", particularly communication, decision-making skills, critical thinking, crisis communication, and teamwork. Practical lectures are complemented by a comprehensive range of simulation teaching methods on simulators with varying degrees of fidelity, trainers, and virtual patients. Simulation results in subsequent debriefing (feedback to the student).

Assessment methods

Language of instruction

English

Further comments (probably available only in Czech)

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

Listed among pre-requisites of other courses

aVLNR09X Neurosurgery
aVLCH0832c || aVLNE9X1c

Teacher's information

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

- Neurological clinic of the University Hospital Brno (FN Brno)

- 1st Department of Neurology of the St. Anne´s University Hospital (FN USA)

The course starts at 8 a.m. and ends at 1 p.m. every day. At the beginning of the first day of their course, the students come to the secretariat of a particular 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)

Students should bring by themselves white coats and neurological hammers. The neurological hammers are available e.g. in the Medical bookstore in the A9 building of the University campus Bohunice (Kamenice 753/5, phone number 54949 3619). Students who take their course in NK FN Brno can borrow the hammer from the secretary (only at the time of their course in NK FN Brno, a returnable deposit of 300,- Czech crowns will be required).

The prerequisite for the course is the basic knowledge of neuroanatomy and neurophysiology (motor pathway: pyramidal tracts, cerebellum, basal ganglia, sensory pathway, thalamus, visual pathway, cranial nerves, neurotransmitters). Starting from the spring semester of 2022, pre-learning available in the interactive syllabus (in Neurology-lecture) is required before the beginning of each course. Before the very start of their practice, students are required to go through the presentations focused on general neurology (and to pass the tests available at the end of each lecture). The prelearning focused on particular topics of special neurology (epileptology, neuromuscular medicine, stroke, and so on) has to be completed before the beginning of the clinical lecture focused on the appropriate topic.

The preclinical knowledge of anatomy and physiology of the nervous system will later be tested by the admission test performed under the supervision of the teacher during the 2nd day of the course at the very latest. To successfully pass the test, a lower limit of 80% of correct answers will be required. The students who fail the admission test have the opportunity to repeat it during the last day of their course (just before the practical exam in Neurology).

- During the first two days of the course, an introduction to neurology propedeutics and neurological examination will be provided and practiced. The knowledge of clinical neurological examination and propaedeutics will be checked by brief oral examinations during the latter part of the course and by the written interim test on the neurological propaedeutics, clinical neurological assessment, paraclinical diagnostic methods in neurology performed during the last week of the course (usually on Wednesday or Friday, i.e. 13th o 15th day of the course).

- The other days of the course consist of a clinical part (provided by both the inpatient and outpatient parts of the neurological department and special labs, i.e. ultrasonography and clinical neurophysiology - EMG, EEG, evoked potentials) and focused workshops with the specialists in particular fields of neurology. Two days of the course take place in the Department of Children's Neurology (Children´s Hospital, Černopolní 9, Building G, 4th floor) to provide the basics of child neurology (developmental neurology, neurodevelopmental disorders, cerebral palsy, neuromuscular diseases in childhood, pediatric epileptology). We highly recommend the students substitute one of their morning lectures with the afternoon one (e.g. from 11:00 a.m. to 4:00 p.m. – i.e. including the morning workshop) or alternatively by their attendance in one evening/night duty (based on the individual appointment with the teacher responsible for a particular course). To reach the maximal practical impact of such a substitution, it is preferred to perform it during the second or third week of the course.

During the last (15th) day of the course, the students undergo the PRACTICAL EXAM (classified credit), which represents an integral part of the final exam in Neurology and consists of:

a. clinical examination of the patient (incl. medical history), syndromological, topical, and differential diagnosis;

b. oral exam focused on clinical neurological examination, neurological propedeutics, and the indication and interpretation of basic paraclinic examinations used in neurological patients.

WE ASK THE STUDENTS FOR KEEPING ON THEIR MINDS THAT THE SCHEDULE OF THEIR COURSE CAN´T BE CHANGED (with the exception of a few very serious reasons – stays abroad, long-term disease).

More detailed information (including the timetable of your course) are available on the notice boards at the secretariats of particular departments. For further details, you can also ask the deputy head of a particular clinic:

- In FN Brno: asociate professor Pavel Štourač, MD, Ph.D. (štourač.pavel@fnbrno.cz)

- In FN USA: associate professor Marek Baláž, MD, Ph.D. (marek.balaz@fnusa.cz)

- In FDN assistant professor Ondřej Horák, MD (horak.ondrej@fnbrno.cz).

The course is also listed under the following terms Autumn 2017, Spring 2018, autumn 2018, spring 2019, autumn 2019, spring 2020, autumn 2020, spring 2021, autumn 2021, spring 2022, autumn 2022, autumn 2023, spring 2024.

Enrolment Statistics (spring 2023, recent)
Permalink: https://is.muni.cz/course/med/spring2023/aVLNE9X1c

LF:aVLNE9X1c Neurology - practice - Course Information

aVLNE9X1c Neurology - practice

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