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// ─── HELPERS ─────────────────────────────────────────────────────
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// ═══════════════════════════════════════════════════════════════════
// SLIDE 1 — TITLE
// ═══════════════════════════════════════════════════════════════════
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// ═══════════════════════════════════════════════════════════════════
// SLIDE 2 — TABLE OF CONTENTS
// ═══════════════════════════════════════════════════════════════════
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    ["02", "Stroke & Cerebrovascular Disease"],
    ["03", "Epilepsy & Seizure Disorders"],
    ["04", "Movement Disorders (Parkinson's, Tremor, Dystonia)"],
    ["05", "Dementia & Cognitive Disorders"],
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// ═══════════════════════════════════════════════════════════════════
// SECTION 1 — NEUROLOGICAL EXAM & LOCALIZATION (Slides 3–10)
// ═══════════════════════════════════════════════════════════════════
addSection("01  Neurological Examination\n& Localization", "The Foundation of Clinical Neurology");

addContent("The Neurological Examination — Overview", [
  "Mental status: orientation, attention, memory, language, praxis, visuospatial",
  "Cranial nerves: CN I–XII systematically tested",
  "Motor system: tone, bulk, power (MRC 0–5 scale), reflexes",
  "Sensory system: light touch, pinprick, vibration, proprioception, cortical sensation",
  "Cerebellar function: coordination, gait, stance (Romberg)",
  "Gait analysis: heel-toe, tandem, heel-walk, toe-walk",
  "Frontal release signs: grasp, snout, glabellar in diffuse cortical disease",
], "Tip: Always examine gait — it integrates motor, cerebellar, and sensory systems");

addTwoCols("Localizing the Lesion — Key Principles",
  "Upper Motor Neuron (UMN)", [
    "Spasticity (velocity-dependent tone ↑)",
    "Weakness — pyramidal distribution",
    "Hyperreflexia + clonus",
    "Extensor plantar response (Babinski +)",
    "No significant muscle wasting",
    "Location: cortex, corona radiata, brainstem, spinal cord above anterior horn",
  ],
  "Lower Motor Neuron (LMN)", [
    "Flaccidity — reduced tone",
    "Profound weakness + muscle atrophy",
    "Fasciculations may be present",
    "Hyporeflexia or areflexia",
    "Flexor plantar response (if present)",
    "Location: anterior horn, nerve root, peripheral nerve, NMJ, muscle",
  ],
  "UMN vs LMN — always localize before ordering tests"
);

addTable("Cranial Nerve Summary",
  ["CN", "Name", "Function", "Test at Bedside"],
  [
    ["I",   "Olfactory",   "Smell",                      "Coffee / cloves each nostril"],
    ["II",  "Optic",       "Vision / pupil afferent",    "Acuity, fields, RAPD"],
    ["III", "Oculomotor",  "EOM (up/down/in), ptosis",   "Extraocular movements, pupil"],
    ["IV",  "Trochlear",   "Intorsion, down-in gaze",    "Head tilt test"],
    ["V",   "Trigeminal",  "Facial sensation / mastication", "Corneal reflex, jaw clench"],
    ["VI",  "Abducens",    "Lateral gaze",               "Lateral EOM"],
    ["VII", "Facial",      "Facial expression",          "Raise brows, close eyes, smile"],
    ["VIII","Vestibulocochlear","Hearing / balance",      "Finger rub, Weber/Rinne"],
    ["IX/X","Glossopharyngeal/Vagus","Swallow, gag, voice","Palate elevation, gag reflex"],
    ["XI",  "Accessory",   "SCM, trapezius",             "Head turn against resistance"],
    ["XII", "Hypoglossal", "Tongue movement",            "Tongue protrusion (deviates to weak side)"],
  ],
  "CN III palsy with pupil involvement = posterior communicating artery aneurysm until proven otherwise"
);

addContent("Sensory Localization", [
  "Cortical (parietal lobe): astereognosis, agraphesthesia, sensory neglect, +/- pain/temp deficit",
  "Thalamus (VPL/VPM): contralateral hemisensory loss (all modalities); thalamic pain syndrome",
  "Brainstem (lateral medulla): ipsilateral face + contralateral body (Wallenberg pattern)",
  "Cervical cord: level sensory loss, dissociated if hemicord (Brown-Séquard)",
  "Dorsal columns (vibration/proprioception) vs spinothalamic (pain/temp) dissociation helps localize",
  "Peripheral nerve: stocking-glove for length-dependent neuropathy; dermatomal for radiculopathy",
  "Nerve root vs peripheral nerve territory: key for distinguishing radiculopathy vs mononeuropathy",
], "Dissociated sensory loss = classic for spinal cord or brainstem (NOT cortex)");

addContent("Reflex Grading & Clinical Pearls", [
  "0 = Absent | 1+ = Diminished | 2+ = Normal | 3+ = Brisk | 4+ = Clonus",
  "Reinforcement (Jendrassik): tighten fingers or clench teeth when testing lower limb reflexes",
  "Hoffman sign: pathological flexion of thumb/index on flicking middle finger = UMN cervical cord",
  "Babinski sign: slow upgoing toe + fanning = corticospinal tract lesion",
  "Primitive reflexes (palmomental, snout, grasp): frontal lobe dysfunction",
  "Areflexia at presentation in Guillain-Barré Syndrome is a hallmark finding",
  "Pendular reflexes: cerebellar disease (no dampening by normal tone)",
], "Asymmetric reflexes are often more significant than absolute grade");

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  "Gait Type → Localization", [
    "Hemiplegic (circumduction) → Contralateral UMN / stroke",
    "Steppage (foot drop) → L4-L5, common peroneal nerve",
    "Trendelenburg → Gluteus medius weakness / L5",
    "Scissor (spastic paraparesis) → Bilateral UMN / spinal cord",
    "Ataxic (wide-based) → Cerebellum / dorsal columns",
    "Antalgic (pain-avoidance) → Musculoskeletal",
  ],
  "Clinical Traps", [
    "Functional (psychogenic): varies, 'Hoover sign', astasia-abasia",
    "Normal pressure hydrocephalus: 'magnetic gait', small shuffling steps, wide-based",
    "Parkinson's: festination, reduced arm swing, en-bloc turns, start hesitation",
    "Myopathic (waddling): Trendelenburg bilateral → proximal hip weakness",
    "Vestibular (imbalance): falls toward lesion side, normal with visual fixation",
  ],
  "Observe gait early — before the patient is aware they are being watched"
);

addHighlight("Localization Principle", 
  '"Diagnose first by anatomy, then by pathology"',
  "Determine WHERE the lesion is (cortex / subcortex / brainstem / spinal cord / PNS) before deciding WHAT the lesion is. This minimizes unnecessary testing and diagnostic anchoring.",
  SILVER
);

// ═══════════════════════════════════════════════════════════════════
// SECTION 2 — STROKE (Slides 11–20)
// ═══════════════════════════════════════════════════════════════════
addSection("02  Stroke & Cerebrovascular\nDisease", "Time Is Brain — 1.9 Million Neurons/Minute");

addContent("Stroke Epidemiology & Classification", [
  "Stroke: 2nd leading cause of death worldwide; leading cause of adult disability",
  "Ischemic stroke: ~87% of all strokes (large artery, cardioembolic, lacunar, cryptogenic, other)",
  "Hemorrhagic: ~13% (intracerebral hemorrhage 10%, subarachnoid hemorrhage 3%)",
  "TOAST classification: Large-artery atherosclerosis, Cardioembolic, Small-vessel, Other, Cryptogenic",
  "TIA: focal neurological deficit from ischemia, fully resolving — no infarct on DWI",
  "ABCD² score risk-stratifies TIA for early recurrent stroke",
  "Stroke incidence rising in young adults (ages 18–50) — consider dissection, PFO, hypercoagulable",
], "Every minute without reperfusion = ~1.9 million neurons lost");

addTwoCols("Ischemic Stroke Syndromes",
  "Anterior Circulation (ICA territory)", [
    "MCA (superior division): contralateral face + arm > leg weakness, Broca's aphasia (L)",
    "MCA (inferior division): Wernicke's aphasia (L), contralateral neglect (R), hemianopia",
    "MCA complete: dense hemiplegia + hemisensory + gaze deviation toward lesion",
    "ACA: contralateral leg > arm weakness, urinary incontinence, abulia",
    "Anterior choroidal: hemiplegia + hemisensory + homonymous hemianopia (small lacunar)",
  ],
  "Posterior Circulation (vertebrobasilar)", [
    "PCA: contralateral homonymous hemianopia ± thalamic signs",
    "Basilar artery: 'locked-in syndrome' (bilateral pontine), vertical gaze palsy, coma",
    "PICA / Lateral medulla (Wallenberg): ipsilateral face + contralateral body pain/temp loss, Horner, dysphagia, vertigo, nausea",
    "AICA: ipsilateral CN VII, VIII, Horner; contralateral pain/temp",
    "Cerebellar infarct: ataxia, nausea/vomiting — beware posterior fossa edema",
  ],
  "Posterior circulation strokes are frequently missed on initial ED evaluation"
);

addContent("Acute Ischemic Stroke — Emergency Management", [
  "ABC stabilization; establish time of onset (or last-known-well)",
  "Stat non-contrast CT head: rule out hemorrhage before thrombolysis",
  "IV tPA (alteplase 0.9 mg/kg, max 90 mg): within 3–4.5 hours of onset",
  "CT Angiography (CTA head + neck): identify large vessel occlusion (LVO) for thrombectomy",
  "Mechanical thrombectomy: LVO within 6–24 h if imaging criteria met (DAWN / DEFUSE-3)",
  "BP target: <185/110 mmHg before tPA; allow permissive hypertension if no tPA given",
  "Aspirin 325 mg within 24–48 h (after hemorrhage excluded and tPA window passed)",
  "Admit to stroke unit — reduces mortality and disability independent of other therapies",
], "Door-to-needle <60 min / Door-to-groin <90 min are quality benchmarks");

addTable("tPA Contraindications (Key Points)",
  ["Category", "Contraindication"],
  [
    ["Time",       "Onset > 4.5 hours or unknown time (without advanced imaging)"],
    ["Imaging",    "Hemorrhage on CT; large hypodensity > 1/3 MCA territory"],
    ["BP",         "BP > 185/110 mmHg that cannot be controlled"],
    ["Coagulation","INR > 1.7, platelet < 100k, therapeutic heparin, NOAC within 48 h"],
    ["History",    "ICH ever; ischemic stroke or serious head trauma within 3 months"],
    ["Structural", "Known AVM, intracranial neoplasm, intracranial or spinal surgery within 3 months"],
    ["Glucose",    "Blood glucose < 50 or > 400 mg/dL (may mimic stroke)"],
  ],
  "Relative contraindications exist — always weigh risk/benefit; consult vascular neurology"
);

addContent("Stroke Secondary Prevention", [
  "Antiplatelet therapy: aspirin 81–325 mg/day; or clopidogrel; dual antiplatelet (DAPT) for 21 days post-minor stroke/TIA (POINT trial)",
  "Anticoagulation: for atrial fibrillation → NOAC preferred over warfarin (ROCKET-AF, ARISTOTLE)",
  "Blood pressure control: target <130/80 mmHg; reduce recurrence by ~34%",
  "Statin therapy: high-intensity statin for atherosclerotic stroke (LDL <70 mg/dL target)",
  "PFO closure: consider in cryptogenic stroke in patients < 60 years (CLOSE, RESPECT trials)",
  "Carotid endarterectomy (CEA): symptomatic stenosis >70% (NNT ~6); 50–69% also benefits",
  "Lifestyle: smoking cessation, exercise, Mediterranean diet, weight management",
], "Risk factor modification is the most impactful long-term stroke prevention strategy");

addTwoCols("Intracerebral Hemorrhage (ICH)",
  "Etiologies & Locations", [
    "Hypertensive ICH: basal ganglia, thalamus, pons, cerebellum (deep perforators)",
    "Cerebral amyloid angiopathy (CAA): lobar hemorrhage in elderly, multiple microbleeds",
    "Anticoagulant-related: increasing with warfarin + NOAC use",
    "AVM / cavernous malformation: younger patients, recurrent hemorrhage",
    "Hemorrhagic transformation of ischemic stroke",
    "Tumoral hemorrhage: ring-enhancing lesion",
  ],
  "Management Priorities", [
    "BP reduction: target SBP 130–150 mmHg within 2 hours (AHA 2022)",
    "Reverse anticoagulation: FFP + Vitamin K (warfarin); PCC (factor Xa inhibitors); idarucizumab (dabigatran)",
    "Platelet transfusion: generally NOT recommended (PATCH trial)",
    "Hematoma expansion: 33% expand within 24 h — ICH score guides prognosis",
    "Surgical evacuation: cerebellar ICH > 3 cm with brainstem compression",
    "Avoid aggressive hyperventilation — use only for acute herniation",
  ],
  "ICH Score (0–6): GCS, ICH volume, IVH, infratentorial location, age >80"
);

addContent("Subarachnoid Hemorrhage (SAH)", [
  "Classic presentation: 'thunderclap headache' — worst headache of life, sudden onset, maximal at onset",
  "Cause: ruptured saccular (berry) aneurysm (~75%), AVM, perimesencephalic non-aneurysmal",
  "Hunt-Hess grade (I–V) and WFNS grade predict prognosis",
  "CT head: 98% sensitive within 6 h — blood in cisterns, sulci (star pattern)",
  "Lumbar puncture if CT negative: xanthochromia after 2 hours, elevated RBC not clearing",
  "CTA or DSA (gold standard) to identify aneurysm — coiling vs clipping decision",
  "Complications: rebleeding (highest risk first 24 h), vasospasm (days 4–14), hydrocephalus, hyponatremia (SIADH vs CSW)",
], "Do NOT dismiss thunderclap headache — LP is mandatory even with normal CT");

addTable("Modified Rankin Scale (mRS)",
  ["Score", "Description", "Independence"],
  [
    ["0", "No symptoms", "Full"],
    ["1", "No significant disability — carries out all usual activities", "Full"],
    ["2", "Slight disability — unable to carry out all previous activities; independent", "Independent"],
    ["3", "Moderate disability — requires some help; walks without assistance", "Partial"],
    ["4", "Moderately severe — unable to walk or attend to needs without help", "Dependent"],
    ["5", "Severe disability — bedridden, incontinent, requires constant nursing care", "Fully dependent"],
    ["6", "Dead", "-"],
  ],
  "mRS ≤2 = good functional outcome; primary endpoint in most stroke trials"
);

addContent("Cerebral Venous Sinus Thrombosis (CVST)", [
  "Often in young women, pregnancy/puerperium, OCP use, hypercoagulable states, malignancy",
  "Symptoms: headache (most common), seizures, focal deficits, papilledema, altered consciousness",
  "MRI/MRV preferred; CT venography also useful — 'empty delta sign' on contrast CT",
  "Treatment: anticoagulate with heparin or LMWH even if hemorrhagic — reduces mortality",
  "DOACs (dabigatran, rivaroxaban) shown non-inferior to warfarin for long-term treatment (RE-SPECT CVST)",
  "Duration: 3–12 months depending on etiology; indefinite if recurrent or major thrombophilia",
  "Prognosis generally good — >80% functional independence with early anticoagulation",
], "Anticoagulate CVST despite hemorrhagic transformation — counterintuitive but evidence-based");

// ═══════════════════════════════════════════════════════════════════
// SECTION 3 — EPILEPSY (Slides 21–28)
// ═══════════════════════════════════════════════════════════════════
addSection("03  Epilepsy & Seizure Disorders", "Recurrent Unprovoked Seizures — Diagnosis to Long-Term Management");

addContent("Seizure Classification (ILAE 2017)", [
  "Focal onset: aware (simple partial) vs impaired awareness (complex partial)",
  "Focal → bilateral tonic-clonic (secondarily generalized)",
  "Generalized onset: motor (tonic-clonic, tonic, clonic, myoclonic, atonic) vs non-motor (absence)",
  "Unknown onset: when onset undetermined",
  "Unprovoked seizure: no reversible cause — carries risk of recurrence (~40–50% within 10 yrs)",
  "Provoked/acute symptomatic: metabolic, toxic, structural, CNS infection — risk ≠ epilepsy risk",
  "Epilepsy: ≥2 unprovoked seizures >24 h apart, OR 1 unprovoked seizure + ≥60% recurrence risk, OR epilepsy syndrome",
], "ILAE 2017 classification organizes seizures by onset, motor features, and awareness");

addTwoCols("Common Epilepsy Syndromes",
  "Childhood / Adolescent Onset", [
    "Benign epilepsy with centrotemporal spikes (BECTS/SELF): centrotemporal spikes, hemifacial clonic, age 3–12, remits",
    "Childhood absence epilepsy (CAE): 3 Hz spike-wave, staring, lip smacking, tx ethosuximide",
    "Juvenile myoclonic epilepsy (JME): morning myoclonus, GTC, absence; lifelong AED often needed",
    "Lennox-Gastaut syndrome: multiple seizure types, slow spike-wave < 2.5 Hz, cognitive impairment",
    "Dravet syndrome: SCN1A mutation, febrile hemiclonic seizures, treatment-refractory",
  ],
  "Adult Epilepsy", [
    "Temporal lobe epilepsy (TLE): most common adult focal epilepsy; mesial temporal sclerosis; déjà vu, automatisms, postictal confusion",
    "Frontal lobe epilepsy: brief nocturnal seizures, hypermotor features, minimal postictal confusion",
    "Occipital epilepsy: visual hallucinations, ictal blindness, post-ictal headache",
    "Post-stroke epilepsy: risk highest in cortical + hemorrhagic stroke; usually within 2 years",
    "Autoimmune epilepsy: new-onset refractory status, CSF pleocytosis, LGI1/NMDAR antibodies",
  ],
  "Identify syndrome early — guides AED choice and prognosis"
);

addContent("Anti-Epileptic Drug (AED) Selection", [
  "Focal epilepsy first-line: levetiracetam, lamotrigine, carbamazepine, oxcarbazepine (lacosamide second-line)",
  "Generalized epilepsy first-line: valproate (most broad), lamotrigine, levetiracetam",
  "Absence seizures: ethosuximide (first-line), valproate — avoid carbamazepine (may worsen)",
  "JME: valproate most effective; levetiracetam alternative; avoid carbamazepine, phenytoin",
  "Women of childbearing potential: avoid valproate (teratogen — neural tube defects, cognitive effects)",
  "Elderly: prefer lamotrigine, levetiracetam; avoid carbamazepine (cardiac conduction, hyponatremia)",
  "Drug interactions: enzyme inducers (carbamazepine, phenytoin, phenobarbital) affect OCPs, warfarin, statins",
], "Valproate — avoid in women of childbearing potential unless no alternatives (NICE, AAN 2020)");

addTable("AED Side Effect Profiles",
  ["Drug", "Key Side Effects", "Monitoring"],
  [
    ["Levetiracetam",  "Irritability, behavioral changes ('keppra rage'), somnolence",     "CBC, metabolic panel annually"],
    ["Lamotrigine",    "Rash, SJS/TEN (titrate slowly), insomnia, dizziness",             "Slow titration, skin checks"],
    ["Carbamazepine",  "Hyponatremia, diplopia, bone marrow suppression, teratogen",      "CBC, Na, LFT; HLA-B*1502 before use"],
    ["Valproate",      "Weight gain, tremor, hair loss, hepatotoxicity, teratogen",       "LFT, ammonia, CBC, drug level"],
    ["Phenytoin",      "Nystagmus, ataxia, gingival hyperplasia, hirsutism, zero-order", "Drug level (narrow therapeutic window)"],
    ["Topiramate",     "Cognitive slowing ('dopamax'), weight loss, nephrolithiasis, glaucoma", "Bicarbonate, eye exam"],
    ["Lacosamide",     "PR prolongation, dizziness — fewer drug interactions",            "ECG before and after initiation"],
  ],
  "Always check HLA-B*1502 in patients of Asian ancestry before starting carbamazepine (SJS risk)"
);

addContent("Status Epilepticus — Emergency Protocol", [
  "Convulsive status epilepticus (CSE): seizure ≥5 min OR ≥2 seizures without return to baseline",
  "Phase 1 (0–5 min): ABC, IV access, blood glucose, lorazepam 0.1 mg/kg IV (max 4 mg/dose)",
  "Phase 2 (5–20 min): Second benzodiazepine dose if seizing, start fosphenytoin 20 PE/kg IV OR levetiracetam 60 mg/kg IV OR valproate 40 mg/kg IV",
  "Phase 3 (20–40 min): Third-line — repeat or second IV AED from above list",
  "Refractory SE (>30–40 min): intubate, propofol or midazolam infusion, continuous EEG monitoring",
  "Super-refractory SE (>24 h anesthesia): consider ketamine, phenobarbital, immunotherapy",
  "Identify and treat underlying cause: hypoglycemia, hyponatremia, CNS infection, NCSE, AE",
], "Early aggressive treatment of SE reduces morbidity — every minute of delay worsens outcome");

addContent("Autoimmune Encephalitis — Key Points", [
  "Presents as new-onset psychiatric symptoms + seizures + cognitive decline + movement disorder",
  "NMDA-R encephalitis (anti-NMDAR): young women, psychiatric prodrome, orofacial dyskinesias, autonomic instability — often paraneoplastic (ovarian teratoma)",
  "LGI1 encephalitis: faciobrachial dystonic seizures (FBDS) pathognomonic, hyponatremia, temporal MRI changes",
  "CASPR2: Morvan syndrome (neuromyotonia + encephalopathy + autonomic), limbic encephalitis",
  "Diagnosis: serum + CSF antibody panel, EEG (extreme delta brush in NMDAR), MRI T2/FLAIR temporal lobe signal",
  "Treatment: high-dose steroids (methylprednisolone 1 g/day × 5), IVIG, plasma exchange (first-line)",
  "Rituximab/cyclophosphamide for refractory cases; tumor removal improves outcome in paraneoplastic",
], "FBDS + hyponatremia = LGI1 antibody encephalitis until proven otherwise — treat before antibody results return");

addHighlight("Epilepsy Key Number",
  "~30% of epilepsy patients are drug-resistant",
  "Defined as failure of ≥2 adequate AED trials. Early referral to epilepsy surgery center (MRI, video-EEG, neuropsychology) is recommended — surgery can be curative in select focal epilepsy.",
  SILVER
);

// ═══════════════════════════════════════════════════════════════════
// SECTION 4 — MOVEMENT DISORDERS (Slides 29–36)
// ═══════════════════════════════════════════════════════════════════
addSection("04  Movement Disorders", "Parkinson's Disease, Tremor, Dystonia & Related Syndromes");

addContent("Parkinson's Disease — Diagnosis", [
  "Core motor features (TRAP): Tremor (resting, 4–6 Hz, 'pill-rolling'), Rigidity (cogwheel), Akinesia/Bradykinesia, Postural instability",
  "UK Brain Bank Criteria: bradykinesia + ≥1 of (rigidity, rest tremor, postural instability)",
  "Asymmetric onset, good levodopa response = clinical hallmark",
  "Non-motor features (often precede motor): REM sleep behavior disorder (RBD), anosmia, constipation, depression, orthostatic hypotension",
  "Pathology: Lewy bodies (α-synuclein) in substantia nigra → dopaminergic neuron loss",
  "DAT-SPECT scan: differentiates degenerative parkinsonism from essential tremor / drug-induced",
  "Red flags for atypical parkinsonism: early falls, early dementia, autonomic failure, vertical gaze palsy, cerebellar signs, poor levodopa response",
], "RBD (acting out dreams) may precede Parkinson's motor symptoms by 10+ years");

addTable("Atypical Parkinsonian Syndromes (Parkinson-Plus)",
  ["Syndrome", "Key Features", "Pathology"],
  [
    ["Progressive Supranuclear Palsy (PSP)",   "Vertical gaze palsy, early falls (backward), axial rigidity, 'surprised look'", "Tau (4R)"],
    ["Multiple System Atrophy (MSA)",          "Autonomic failure (MSA-A) or Cerebellar (MSA-C) + parkinsonism",               "α-synuclein (GCIs)"],
    ["Corticobasal Syndrome (CBS)",            "Alien limb, apraxia, cortical sensory loss, asymmetric akinesia",               "Tau (4R)"],
    ["Dementia with Lewy Bodies (DLB)",        "Fluctuating cognition, visual hallucinations, parkinsonism, RBD",               "α-synuclein (LBs)"],
    ["Vascular Parkinsonism",                  "Lower body parkinsonism, gait > arm features, small vessel disease on MRI",     "Ischemia"],
    ["Drug-induced Parkinsonism",              "Recent neuroleptic/metoclopramide, symmetric, often tremor-less",               "D2 blockade"],
  ],
  "All atypical parkinsonism = poor levodopa response (partial in MSA), faster progression"
);

addTwoCols("Parkinson's Disease — Pharmacotherapy",
  "Dopaminergic Therapies", [
    "Levodopa/carbidopa: gold standard; most effective symptom control; 'wearing off' and dyskinesia with time",
    "Dopamine agonists (pramipexole, ropinirole, rotigotine patch): good monotherapy in younger patients; impulse control disorders, somnolence, hallucinations",
    "MAO-B inhibitors (rasagiline, selegiline, safinamide): mild symptomatic benefit; possible neuroprotective signal",
    "COMT inhibitors (entacapone): extend levodopa effect; adjunct for wearing-off",
    "Amantadine: mild antiparkinsonian + anti-dyskinesia (NMDA antagonist)",
  ],
  "Non-pharmacological & Surgical", [
    "Exercise: neuroplasticity benefit; LSVT BIG/LOUD programs",
    "Physical / occupational / speech therapy",
    "Deep Brain Stimulation (DBS): STN or GPi; best for motor fluctuations + dyskinesia; preserved cognition required",
    "Levodopa-carbidopa intestinal gel (LCIG): continuous enteral infusion via PEG-J",
    "Focused ultrasound thalamotomy: unilateral tremor",
    "Multidisciplinary care: neurology, PT, OT, SLP, psychiatry, palliative care",
  ],
  "Start early — delay of treatment has no proven benefit (LEAP trial)"
);

addContent("Tremor Classification & Approach", [
  "Rest tremor: worse at rest, improves with action — parkinsonism (4–6 Hz)",
  "Postural tremor: present while maintaining posture against gravity",
  "Action/kinetic tremor: during voluntary movement",
  "Intention tremor: increases toward target — cerebellar lesion",
  "Essential tremor (ET): bilateral postural > kinetic tremor of hands; improves with alcohol; family history common; no rest tremor",
  "Enhanced physiological tremor: anxiety, caffeine, thyrotoxicosis, medications (salbutamol, lithium, valproate)",
  "Treatment of ET: propranolol (first-line) or primidone; DBS/focused ultrasound for refractory",
  "Holmes tremor (rubral): mixed rest + postural + intention; midbrain lesion",
], "Differentiate rest tremor (PD) from intention tremor (cerebellar) — different localization and treatment");

addContent("Dystonia — Classification & Management", [
  "Dystonia: sustained or intermittent muscle contractions causing abnormal postures/repetitive movements",
  "Focal: cervical dystonia (torticollis), blepharospasm, writer's cramp, laryngeal dystonia",
  "Segmental / multifocal / generalized: increasingly involves DYT1 (TOR1A) or other genetic causes",
  "Dopa-responsive dystonia (DRD / Segawa): diurnal fluctuation, dramatic levodopa response, GCH1 mutation — do not miss!",
  "Wilson's disease: young patient with movement disorder + liver disease + Kayser-Fleischer rings — ceruloplasmin",
  "Botulinum toxin injection: first-line for focal dystonia (cervical, blepharospasm, limb)",
  "Deep brain stimulation: GPi DBS for generalized/segmental dystonia with significant disability",
], "Always trial levodopa in young-onset dystonia — DRD is treatable and must not be missed");

addHighlight("Parkinson's Red Flag",
  "Falls in year 1 = PSP until proven otherwise",
  "Early falls (especially backward), vertical saccade limitation (downward > upward), square-wave jerks, and 'surprised expression' point toward PSP rather than idiopathic Parkinson's. Levodopa response is poor. Prognosis is significantly worse.",
  SILVER
);

// ═══════════════════════════════════════════════════════════════════
// SECTION 5 — DEMENTIA (Slides 37–43)
// ═══════════════════════════════════════════════════════════════════
addSection("05  Dementia & Cognitive Disorders", "Alzheimer's Disease, Frontotemporal Dementia & Related Syndromes");

addContent("Dementia — General Approach", [
  "Dementia: acquired cognitive decline in ≥2 domains sufficient to impair daily function",
  "Mild cognitive impairment (MCI): cognitive decline without functional impairment — 10–15% convert to dementia/year",
  "Reversible causes (treatable): B12/folate deficiency, hypothyroidism, neurosyphilis, NPH, subdural hematoma, depression (pseudodementia)",
  "Workup: MMSE / MoCA, basic labs (CBC, CMP, TSH, B12, RPR, HIV), brain MRI",
  "Specialist referral for young-onset (<65 yrs), atypical features, rapid progression, or diagnostic uncertainty",
  "Neuropsychological testing: characterizes profile (memory vs frontal vs visuospatial dominance)",
  "CSF biomarkers (Aβ42, p-tau, t-tau) and amyloid PET increasingly used for AD diagnosis",
], "Always rule out reversible causes before making an irreversible dementia diagnosis");

addTwoCols("Dementia Subtypes — Key Features",
  "Cortical Dementias", [
    "Alzheimer's Disease: episodic memory (hippocampus) earliest; medial temporal atrophy on MRI; tau + amyloid pathology; slow progression over years",
    "Frontotemporal Dementia (FTD) — Behavioral variant: disinhibition, apathy, compulsive behaviors, dietary changes, frontal atrophy; younger onset",
    "FTD — Primary Progressive Aphasia (PPA): language dominant; nonfluent/agrammatic (PNFA), semantic, or logopenic variants",
    "DLB: fluctuating cognition + visual hallucinations + parkinsonism + RBD (all 4 core features diagnostic)",
  ],
  "Subcortical & Other Dementias", [
    "Vascular dementia: stepwise decline + focal signs + white matter changes on MRI; second most common",
    "Normal Pressure Hydrocephalus (NPH): Hakim's triad — gait apraxia, urinary incontinence, dementia; LP test (removes 30–50 mL CSF); treatable with VP shunt",
    "Creutzfeldt-Jakob Disease (CJD): rapidly progressive dementia + myoclonus + cerebellar signs; PSWC on EEG; elevated 14-3-3 in CSF; RT-QuIC for diagnosis",
    "Huntington's disease: autosomal dominant, CAG repeats, chorea + dementia + psychiatric",
  ],
  "CJD: weeks to months progression — always consider in rapidly progressive dementia"
);

addContent("Alzheimer's Disease — Diagnosis & Treatment", [
  "NIA-AA 2018 criteria: biomarker-supported framework (A/T/N: amyloid, tau, neurodegeneration)",
  "Clinical: insidious onset, gradual progression, episodic memory dominant early",
  "MRI: hippocampal and entorhinal cortex atrophy; exclude other structural causes",
  "FDG-PET: temporoparietal hypometabolism in moderate-advanced AD",
  "Amyloid PET: high sensitivity/specificity for amyloid pathology (not just AD)",
  "Cholinesterase inhibitors (donepezil, rivastigmine, galantamine): modest symptomatic benefit; all stages",
  "Memantine (NMDA antagonist): moderate-severe AD; may combine with ChEI",
  "Lecanemab (anti-amyloid mAb): FDA-approved 2023 for early AD — slows progression ~27%; amyloid-related imaging abnormalities (ARIA) monitoring needed",
], "Anti-amyloid therapy (lecanemab, donanemab) represents a new era — use in MCI-to-mild AD stage");

addContent("Frontotemporal Dementia (FTD) — Key Points", [
  "Most common dementia < 65 years (alongside early-onset AD)",
  "Behavioral variant FTD (bvFTD): personality change, disinhibition, loss of empathy, compulsive/ritualistic behaviors, hyperorality",
  "FTD-MND overlap: ~15% of bvFTD have concurrent ALS — poor prognosis",
  "Genetics: C9orf72 hexanucleotide repeat (most common genetic FTD/ALS); MAPT, GRN mutations",
  "Pathology heterogeneous: tau (FTLD-tau), TDP-43 (FTLD-TDP), FUS (FTLD-FUS)",
  "No disease-modifying treatment — management: behavioral symptoms (SSRIs for disinhibition), caregiver support, multidisciplinary team",
  "Semantic dementia: loss of word/concept meaning, temporal lobe atrophy; fluent aphasia",
], "C9orf72 expansion is the most common genetic cause of both FTD and ALS — check in familial cases");

addHighlight("Dementia Screening",
  "MoCA score ≤25 = cognitive impairment",
  "The Montreal Cognitive Assessment (MoCA) is more sensitive than MMSE for MCI detection. A score ≤25/30 warrants further evaluation. Adjustments for education level: +1 point for <12 years of education.",
  SILVER
);

// ═══════════════════════════════════════════════════════════════════
// SECTION 6 — HEADACHE (Slides 44–50)
// ═══════════════════════════════════════════════════════════════════
addSection("06  Headache & Facial Pain Syndromes", "Primary Headache Disorders and Dangerous Secondaries");

addContent("Headache Classification (ICHD-3)", [
  "Primary headaches: migraine, tension-type (TTH), cluster and other trigeminal autonomic cephalalgias (TACs)",
  "Secondary headaches: SAH, CVST, meningitis, intracranial hypertension, giant cell arteritis, spontaneous intracranial hypotension",
  "SNOOP4 red flags for secondary headache: Systemic symptoms, Neurological signs, Onset sudden (thunderclap), Older (>50 new headache), Postural/positional, Papilledema, Progressive worsening, Previous headache change",
  "Thunderclap headache: SAH until proven otherwise — CT head then LP if CT negative",
  "New headache in immunocompromised: cryptococcal meningitis, CNS lymphoma",
  "Headache > 50 years: giant cell arteritis — ESR, CRP, temporal artery biopsy; empiric steroids if suspected",
  "Papilledema + headache: idiopathic intracranial hypertension (IIH) vs space-occupying lesion",
], "Thunderclap = SAH. Sentinel headache may precede rupture by days — do not miss");

addTwoCols("Migraine — Diagnosis & Treatment",
  "Diagnosis (ICHD-3)", [
    "≥5 attacks of 4–72 hour duration",
    "Unilateral, pulsating, moderate-severe intensity",
    "Worse with routine activity",
    "Nausea/vomiting OR photophobia + phonophobia",
    "Migraine with aura: visual (most common), sensory, or speech aura preceding headache; aura builds over 5–20 min",
    "Chronic migraine: ≥15 headache days/month for 3 months, ≥8 of which are migrainous",
    "Medication overuse headache (MOH): analgesic/triptan use ≥10–15 days/month",
  ],
  "Treatment", [
    "Acute (mild-moderate): NSAIDs + metoclopramide or acetaminophen",
    "Acute (moderate-severe): oral triptans (sumatriptan, rizatriptan); gepants (ubrogepant, rimegepant) — no vasoconstriction",
    "Status migrainosus: IV prochlorperazine + ketorolac + IV hydration",
    "Preventive (>4/month): propranolol, topiramate, amitriptyline, valproate, candesartan",
    "CGRP monoclonal antibodies (erenumab, fremanezumab, galcanezumab): monthly/quarterly SC injection; first disease-specific preventive",
    "Botulinum toxin (onabotulinumtoxinA): FDA-approved for chronic migraine, 31 injection protocol every 12 weeks",
  ],
  "MOH: must withdraw offending analgesic — withdrawal is part of the treatment"
);

addContent("Cluster Headache & TACs", [
  "Cluster headache: most painful primary headache; unilateral periorbital/retro-orbital excruciating pain (10/10), 15–180 min duration, 1–8 attacks/day",
  "Ipsilateral autonomic features: lacrimation, rhinorrhea, conjunctival injection, ptosis, miosis, eyelid edema",
  "Circadian and circannual pattern — patient agitated/restless (opposite of migraine)",
  "Acute treatment: high-flow O₂ 100% (12 L/min face mask) × 15 min; subcutaneous sumatriptan 6 mg",
  "Bridge therapy: short prednisone taper + verapamil initiation (dose titrate; ECG monitoring required)",
  "Preventive: verapamil (drug of choice); lithium; topiramate; newer: galcanezumab shows efficacy",
  "Other TACs: SUNCT (short-lasting, most painful, treated with lamotrigine), paroxysmal hemicrania (indomethacin-responsive — diagnostic)",
], "Indomethacin responsiveness is pathognomonic for paroxysmal hemicrania and hemicrania continua");

addContent("Idiopathic Intracranial Hypertension (IIH)", [
  "Typically obese women of childbearing age; headache + pulsatile tinnitus + visual changes + papilledema",
  "Modified Dandy criteria: signs/symptoms of ↑ICP, no localizing neurological signs, normal neuroimaging (except empty sella/transverse sinus stenosis), elevated CSF pressure (>25 cmH₂O), normal CSF composition",
  "MRI brain with MRV preferred: empty sella, slit-like ventricles, transverse sinus stenosis, optic nerve sheath dilation",
  "LP opening pressure ≥25 cmH₂O in lateral decubitus; symptomatic improvement after CSF removal",
  "Treatment: weight loss (most effective long-term); acetazolamide (carbonic anhydrase inhibitor — first-line medical)",
  "Topiramate: alternative with weight-loss benefit",
  "Optic nerve sheath fenestration: for visual loss; VP/LP shunt: for intractable headache",
  "Venous sinus stenting: for significant transverse sinus stenosis (emerging evidence)",
], "Visual field monitoring is critical — papilledema-related blindness is preventable");

// ═══════════════════════════════════════════════════════════════════
// SECTION 7 — NEUROMUSCULAR (Slides 51–57)
// ═══════════════════════════════════════════════════════════════════
addSection("07  Neuromuscular Disease &\nPeripheral Neuropathy", "Nerve, Muscle, and Neuromuscular Junction Disorders");

addContent("Peripheral Neuropathy — Classification", [
  "By fiber type: large fiber (vibration/proprioception/reflexes affected) vs small fiber (pain/temperature/autonomic, normal NCS)",
  "By distribution: length-dependent (stocking-glove) vs mononeuropathy vs multiple mononeuropathy (mononeuritis multiplex) vs radiculopathy",
  "By temporal profile: acute (GBS), subacute (metabolic, toxic), chronic (hereditary, CIDP)",
  "By pathology: axonal (amplitude ↓ on NCS) vs demyelinating (velocity ↓, conduction block, prolonged latencies)",
  "Common causes: diabetes (#1), alcohol, B12 deficiency, hypothyroidism, CIDP, vasculitis, paraprotein, genetic (CMT)",
  "Workup: NCS/EMG to characterize, then targeted labs based on pattern",
  "Skin punch biopsy: quantifies intraepidermal nerve fiber density — gold standard for small fiber neuropathy",
], "Small fiber neuropathy has normal NCS/EMG — skin biopsy or QST/autonomic testing required");

addTable("Approach to Peripheral Neuropathy",
  ["Pattern", "Key Causes", "Key Test"],
  [
    ["Acute demyelinating (GBS)",           "Campylobacter, viral illness, post-vaccination",       "CSF (albuminocytologic dissociation), NCS"],
    ["Chronic demyelinating (CIDP)",        "Idiopathic, paraprotein (POEMS, IgM anti-MAG)",        "CSF protein, SPEP/IFIX, NCS"],
    ["Axonal + painful (small fiber)",      "Diabetes, HIV, Sjogren's, vasculitis, amyloid",        "Skin biopsy, autonomic testing, HbA1c"],
    ["Mononeuritis multiplex",              "Vasculitis (ANCA, PAN), sarcoid, leprosy, diabetes",   "ANCA, cryoglobulins, nerve biopsy"],
    ["Hereditary motor+sensory (CMT)",      "PMP22 duplication (CMT1A) — most common hereditary",   "Gene panel, family history, foot deformity"],
    ["Autonomic neuropathy",                "Diabetes, amyloid, autoimmune (ANNA-1, ganglionic AChR Ab)", "QSART, tilt table, COMPASS-31"],
  ],
  "EMG/NCS is mandatory — it determines axonal vs demyelinating and guides workup"
);

addContent("Guillain-Barré Syndrome (GBS)", [
  "Acute immune-mediated polyradiculoneuropathy; most common acute flaccid paralysis in developed world",
  "Presentation: ascending weakness + areflexia + back pain; nadir within 4 weeks",
  "Variants: AIDP (demyelinating, most common), AMAN (axonal), Miller Fisher syndrome (ataxia + ophthalmoplegia + areflexia, anti-GQ1b Ab)",
  "Triggers: Campylobacter jejuni (AMAN), EBV, CMV, COVID-19, influenza vaccine (rare)",
  "Brighton criteria for diagnosis: bilateral limb weakness + decreased/absent DTRs in weak limbs",
  "CSF: albuminocytologic dissociation — elevated protein, normal cells (week 1–2)",
  "IVIG 2 g/kg over 5 days OR plasma exchange (5 sessions): equally effective — do not combine",
  "Monitor: respiratory function (FVC, NIF), autonomic instability; ICU if bulbar or FVC < 20 mL/kg",
], "FVC <20 mL/kg or 30% fall = impending respiratory failure — early intubation");

addTwoCols("Myasthenia Gravis (MG)",
  "Diagnosis", [
    "Fatigable weakness: ptosis, diplopia, dysarthria, dysphagia, limb weakness — worse with activity",
    "Antibodies: AChR (85%), MuSK (5–8%), LRP4, seronegative (~10%)",
    "Edrophonium (Tensilon) test: brief improvement with acetylcholinesterase inhibitor",
    "Electrophysiology: repetitive nerve stimulation (RNS) — decremental response ≥10%",
    "Single-fiber EMG (SF-EMG): most sensitive test for MG (95%+)",
    "CT chest: thymoma in 10–15% of AChR+ patients; thymic hyperplasia more common",
    "MuSK-MG: predominantly bulbar/respiratory, no thymoma, not responsive to pyridostigmine",
  ],
  "Treatment", [
    "Symptomatic: pyridostigmine (acetylcholinesterase inhibitor); dose-titrate",
    "Immunosuppression: prednisone (careful — may cause initial worsening); azathioprine; mycophenolate",
    "Biologic: eculizumab, ravulizumab (complement C5 inhibitors for AChR+); efgartigimod (FcRn inhibitor)",
    "Rescue therapy: IVIG or PLEX for exacerbations and myasthenic crisis",
    "Thymectomy: improves remission in thymomatous + non-thymomatous AChR+ MG (MGTX trial)",
    "Myasthenic crisis: respiratory failure — ICU, PLEX or IVIG, avoid precipitants",
    "Avoid: aminoglycosides, fluoroquinolones, beta-blockers, magnesium, neuromuscular blockers",
  ],
  "Never use succinylcholine in known MG — unpredictable prolonged block"
);

addContent("Inflammatory Myopathies", [
  "Polymyositis (PM): proximal limb weakness, elevated CK, endomysial inflammation on biopsy — diagnosis of exclusion",
  "Dermatomyositis (DM): proximal weakness + characteristic skin (heliotrope rash, Gottron's papules, V-sign, shawl sign)",
  "Inclusion body myositis (IBM): most common in men >50; DISTAL + proximal weakness; finger flexors + quadriceps; CK mildly elevated; Congo red inclusions on biopsy; treatment-resistant",
  "Immune-mediated necrotizing myopathy (IMNM): statin-associated (anti-HMGCR Ab); rapid severe proximal weakness; highly CK elevated (often >10,000)",
  "Anti-synthetase syndrome: anti-Jo-1 (most common), ILD + myositis + mechanic's hands + arthritis + Raynaud's",
  "Malignancy screening: DM has highest cancer association (especially ovarian, lung, GI); screen all adults",
  "Treatment: high-dose prednisone ± steroid-sparing agents (azathioprine, mycophenolate, IVIG for DM)",
], "IBM does not respond to immunosuppression — recognize it early to avoid unnecessary treatment");

// ═══════════════════════════════════════════════════════════════════
// SECTION 8 — NEURO EMERGENCIES (Slides 58–63)
// ═══════════════════════════════════════════════════════════════════
addSection("08  Neurological Emergencies\n& ICU Neurology", "Herniation, Coma, Brain Death & Neuro-Critical Care");

addContent("Herniation Syndromes", [
  "Uncal (transtentorial) herniation: CN III palsy (fixed dilated pupil + down-and-out) → ipsilateral, then bilateral; contralateral hemiparesis → decerebrate posturing → coma",
  "Central herniation: bilateral pupil changes, Cheyne-Stokes → central neurogenic hyperventilation → ataxic breathing",
  "Subfalcine herniation: cingulate gyrus shifts under falx; ACA territory ischemia → leg weakness",
  "Tonsillar herniation: cerebellar tonsils into foramen magnum → sudden cardiorespiratory arrest",
  "Upward herniation: posterior fossa mass → midbrain compression from below",
  "Management: HOB 30°, hyperventilation (target PCO₂ 35–40, or acute PCO₂ 30–35 for imminent herniation), mannitol 1 g/kg IV bolus, hypertonic saline 23.4% via central line, emergent neurosurgery",
  "Avoid: hypotension, hyperglycemia, hyperthermia, hyponatremia — all worsen cerebral edema",
], "Fixed dilated pupil in head injury = uncal herniation → immediate decompression required");

addContent("Coma Assessment", [
  "GCS: Eye (1–4) + Verbal (1–5) + Motor (1–6) = total 3–15; GCS ≤8 = coma",
  "Brainstem reflexes for level: pupillary light, corneal, oculocephalic (doll's eyes), oculovestibular (caloric), cough/gag",
  "FOUR score: complements GCS with brainstem and respiratory assessment — better for intubated patients",
  "Structural vs metabolic coma: structural = focal signs + abnormal brainstem; metabolic = symmetric, preserved brainstem (early), toxic screen",
  "Urgent workup: non-contrast CT head, blood glucose, ABG, electrolytes, toxicology, ammonia, NCSE on EEG",
  "Prognosis after cardiac arrest: multimodal at 72 h — EEG (burst suppression / background reactivity), SSEP (bilaterally absent N20 = poor), CT/MRI, clinical exam",
  "Vegetative state vs MCS vs locked-in: fMRI / EEG-based communication paradigms changing diagnosis",
], "GCS motor score most predictive of outcome: M1 (none) / M2 (extension) = poor prognosis");

addContent("Brain Death Determination", [
  "Definition: irreversible cessation of all brain functions including brainstem",
  "Prerequisites: established cause, normal temperature (≥36°C), normotension, no sedating drugs/neuromuscular blockade, corrected metabolic/endocrine abnormalities",
  "Clinical exam: coma (no purposeful movements), absent brainstem reflexes (pupils, corneal, oculovestibular, gag, cough), absent respiratory drive",
  "Apnea test: PCO₂ rises ≥20 mmHg above baseline (to >60 mmHg) with no respiratory effort = absent respiratory drive",
  "Confirmatory tests (when clinical determination incomplete): EEG (isoelectric), CTA/MRA (no intracranial blood flow), nuclear medicine CBF scan, SSEP",
  "Two physician examinations often required (institution-specific) with defined time interval",
  "Legal/ethical: brain death = death by neurological criteria; family communication, organ donation discussion",
], "Brain death = legal death in all 50 states and most countries — documentation must be meticulous");

addTable("Neuro-ICU Monitoring & Management Targets",
  ["Parameter", "Target", "Rationale"],
  [
    ["ICP",                "<20 mmHg",                     "Above 20 requires treatment; >25 aggressive management"],
    ["CPP",                "60–70 mmHg (MAP – ICP)",       "Adequate cerebral perfusion; avoid hypotension"],
    ["PaCO₂",             "35–40 mmHg (maintenance)",      "Hyperventilation for acute herniation only"],
    ["PaO₂",              ">60 mmHg; SpO₂ >94%",          "Hypoxia worsens ischemic injury"],
    ["Temperature",        "Normothermia (36–37.5°C)",     "Fever increases CMRO₂; 0.5°C rise = 7% ↑ metabolism"],
    ["Blood glucose",      "140–180 mg/dL",                "Tight control increases hypoglycemia risk"],
    ["Sodium",             "135–145; hypernatremia for ICP","Hyponatremia → brain edema"],
    ["Seizure prophylaxis","Phenytoin/levetiracetam × 7 days post-TBI", "Evidence for penetrating/severe TBI only"],
  ],
  "ICP monitoring: GCS ≤8 + CT abnormality after TBI is standard indication"
);

addContent("Neuro-Oncology Essentials", [
  "Glioblastoma (GBM, WHO grade 4): most common malignant primary brain tumor; median survival 15 months with Stupp protocol (temozolomide + RT + bevacizumab)",
  "Lower-grade gliomas (WHO grade 2–3): IDH mutation + 1p/19q co-deletion (oligodendroglioma) better prognosis; IDH-mutant astrocytoma intermediate",
  "Meningioma: most common benign brain tumor; WHO grade 1 (most); observe, radiosurgery, or surgery based on size/growth/symptoms",
  "Brain metastases: most common brain tumor overall; lung, breast, melanoma, colon, renal cell; whole brain RT vs stereotactic radiosurgery vs surgical resection based on number/size",
  "Primary CNS lymphoma (PCNSL): periventricular enhancement, often in immunocompromised; methotrexate-based chemotherapy",
  "Leptomeningeal disease: headache + multiple cranial nerve palsies; CSF cytology + MRI spine with gadolinium",
  "SMART syndrome: stroke-like migraine attacks after radiation therapy — late complication of brain RT",
], "IDH mutation = most important prognostic biomarker in diffuse gliomas (WHO 2021 CNS tumor classification)");

// ═══════════════════════════════════════════════════════════════════
// SLIDE 64 — SUMMARY / KEY TAKEAWAYS
// ═══════════════════════════════════════════════════════════════════
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    ["02", "Time is brain in stroke",              "Door-to-needle <60 min / LVO → thrombectomy up to 24 h with imaging guidance."],
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    ["04", "Levodopa is still king in PD",         "Start early; red flags for atypical parkinsonism change management and prognosis."],
    ["05", "Reversible causes first in dementia",  "B12, thyroid, NPH — treat these before accepting a neurodegenerative diagnosis."],
    ["06", "Thunderclap = SAH until disproven",    "CT + LP mandatory. Missing it is a catastrophic error."],
    ["07", "Respiratory vigilance in NMD",         "GBS, MG crisis — monitor FVC/NIF; early ICU transfer saves lives."],
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// ═══════════════════════════════════════════════════════════════════
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