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1 ORGANIZATION OF THE NERVOUS SYSTEM1

Introduction2

Overview of brain anatomy2

Internal anatomy of the brain5

Ventricular system10

Forebrain11

Hemisphere specialization12

Limbic system14

Orbitofrontal cortex17

Basal ganglia17

Diencephalon17

Thalamus18

Hypothalamus19

Peripheral nervous system21

Putting it all together:from anatomy to behaviour29

2 ELEMENTS OF CELLULAR AND MOLECULAR NEUROSCIENCE31

Introduction32

Neurones32

Glial cells34

Neurone excitability35

Neurotransmitters41

Postsynaptic events and postsynaptic receptors42

3 CLINICAL EXAMINATION47

Introduction48

Parts of the clinical examination48

Other investigations55

General comments57

4 THE SPINAL CORD59

Introduction60

Gross anatomy of the spinal cord and vertebral column60

Functional organization of the spinal cord61

Spinal cord cell types63

Receptive fields64

Somatosensory pathways65

Blood supply to the spinal cord71

Damage to the spinal cord72

Comments on the case history78

5 PAIN AND ANALGESIA79

Introduction80

Nociceptors81

Pain pathways82

How does the central nervous system interpret a stimulus as painful?84

Physiology of pain modulation86

Pain mechanisms after tissue damage:peripheral and central sensitization90

Neuropathic pain mechanisms92

Pharmacology of pain93

Other approaches to pain management99

General comments on pain management104

6 CRANIAL NERVES AND THE BRAINSTEM105

Introduction106

Anatomical organization of cranial nerves in the brain106

Internal organization of the brainstem107

Reticular formation109

Blood supply to the brainstem112

Brainstem reflexes112

Brainstem lesions116

Comments on the case history118

7 THE VISUAL SYSTEM121

Introduction122

Structure of the eye122

Visual pathways125

Visual field defects127

Pupillary light reflexes127

Focusing of light on the retina127

Control of eye movements130

Structure and function of the retina131

Processing of visual information137

Summary140

8 HEARING AND BALANCE:THE AUDITORY AND VESTIBULAR SYSTEMS141

Introduction142

The auditory system142

The vestibular system152

Comments on the case history158

9 MOTOR SYSTEMS Ⅰ:DESCENDING PATHWAYS AND CEREBELLUM159

Introduction160

Skeletal muscle contraction161

Reflexes164

Descending pathways167

Clinical importance of reflexes172

The cerebellum175

10 MOTOR SYSTEMS Ⅱ:THE BASAL GANGLIA181

Introduction182

The basal ganglia:structure and organization182

Parkinson's disease184

Huntington's disease194

11 STROKE AND HEAD INJURY199

Introduction200

Physiological control of cerebral blood flow200

Blood supply to the brain201

Venous system204

Functional anatomy of the cerebral vasculature205

Angiography206

Stroke206

Head injury219

Comments on the case history225

12 INFECTION IN THE CENTRAL NERVOUS SYSTEM227

Introduction228

Types of infection of the central nervous system228

The meninges229

Cerebrospinal fluid production and circulation230

The blood-brain barrier232

Meningitis232

Diagnosis and treatment of meningitis234

Treatment of meningitis235

Encephalitis235

Cerebral abscesses235

Brain infections in the immunocompromised patient236

13 EPILEPSY237

Introduction238

General description of epilepsy238

Epidemiology of epilepsy238

Types of epileptic syndrome239

Diagnostic investigations of epilepsy239

Different types of seizure242

Neurobiology of epilepsy243

Pharmacological treatment of epilepsy246

Other treatments for epilepsy248

Treatment of status epilepticus249

Social consequences of epilepsy249

14 DEMENTIA251

Introduction252

Causes and diagnosis of dementia252

Neurobiology of learning and memory253

Alzheimer's disease256

Treatment of Alzheimer's disease261

Other types of dementia263

General considerations in the management of Alzheimer's disease and other types of dementia265

15 SCHIZOPHRENIA267

Introduction268

Schizophrenia:the clinical diagnosis268

Aetiology of schizophrenia271

Neurobiology of schizophrenia272

Treatment of schizophrenia275

Comments on the management of schizophrenia and the long-term prognosis278

Other psychoses and schizophrenia-like syndromes279

16 DEPRESSION AND ANXIETY281

Introduction282

Classification of mood disorders282

Clinical features of mood disorders282

Epidemiology of depression and natural evolution of the disease283

Genetics of mood disorders283

Neurobiology of depression286

Treatment of depression287

Bipolar disorder and its treatment292

General comments on mood disorders293

Need for new therapeutic targets294

Comments on the case history294

Anxiety disorders294

Treatment of anxiety disorders295

Insomnia297

17 ADDICTION301

Introduction302

Addiction and drug misuse:general comments302

Opiates302

Cocaine and crack304

Cannabis305

Nicotine307

Alcohol308

Phencyclidine309

Amphetamines310

Ecstasy-or the beginning of agony?310

Hallucinogens311

Solvents311

Neurobiology of addiction312

Addiction and rehabilitation:general issues313

Index315