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Detailed clinical learning notes for a medical student on the following topics Stroke Epilepsy Coma Epilepsy Headache Parkinson's Disease

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These notes are drawn directly from the medical library, covering all 5 topics (Epilepsy listed once, as requested). Here is a quick guide to what is included:

What These Notes Cover

1. Stroke
  • Epidemiology (800,000/yr US; 87% ischemic)
  • TOAST classification (large artery, cardioembolic, lacunar, cryptogenic)
  • Vascular territory syndromes (MCA, ACA, PCA, lacunar, posterior fossa)
  • Acute management: IV tPA (≤4.5h), endovascular thrombectomy (LVO ≤24h), BP targets
  • Secondary prevention by mechanism, post-stroke complications
2. Epilepsy
  • ILAE 2017 seizure classification (focal aware/impaired awareness/to bilateral tonic-clonic; generalised types)
  • EEG interpretation: epileptiform discharges, photoparoxysmal response
  • Key syndromes: childhood absence, JME, temporal lobe epilepsy, West syndrome, Lennox-Gastaut
  • AED table: mechanism, indication, key side effects (including valproate teratogenicity)
  • Status epilepticus stepwise management
3. Coma
  • Spectrum of consciousness (drowsiness → stupor → coma)
  • Pathophysiology (ARAS + bilateral cortex; herniation syndromes)
  • AEIOU TIPS mnemonic for causes
  • Full GCS table (adult + paediatric scoring)
  • FOUR score; pupillary signs by lesion level
  • Vegetative state, MCS, locked-in syndrome, brain death - key distinctions
  • Emergency assessment and management approach
4. Headache
  • Red flag features (SNOOPS4) + imaging indications
  • Migraine: pathophysiology (CSD, trigeminovascular system, CGRP), ICHD-3 criteria, acute (triptans, gepants) and prophylactic treatment (propranolol, topiramate, CGRP mAbs)
  • Tension-type headache vs migraine
  • Cluster headache: autonomic features, acute O₂ + sumatriptan, verapamil prophylaxis
  • Medication overuse headache
5. Parkinson's Disease
  • TRAP motor features, Braak staging, alpha-synuclein/Lewy body pathology
  • Non-motor features (RBD, anosmia, depression, autonomic)
  • UK Brain Bank diagnostic criteria, DaTscan
  • Parkinson's Plus differentials (PSP, MSA, CBD, DLB) with distinguishing features
  • Levodopa pharmacology and motor complications (wearing off, dyskinesia)
  • Full drug table: levodopa/carbidopa, dopamine agonists, MAO-B inhibitors, COMT inhibitors, amantadine, anticholinergics
  • DBS indications; neuropsychiatric management
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