1 ORGANIZATION OF THE NERVOUS SYSTEM 1
Introduction 2
Overview of brain anatomy 2
Internal anatomy of the brain 5
Ventricular system 10
Forebrain 11
Hemisphere specialization 12
Limbic system 14
Orbitofrontal cortex 17
Basal ganglia 17
Diencephalon 17
Thalamus 18
Hypothalamus 19
Peripheral nervous system 21
Putting it all together:from anatomy to behaviour 29
2 ELEMENTS OF CELLULAR AND MOLECULAR NEUROSCIENCE 31
Introduction 32
Neurones 32
Glial cells 34
Neurone excitability 35
Neurotransmitters 41
Postsynaptic events and postsynaptic receptors 42
3 CLINICAL EXAMINATION 47
Introduction 48
Parts of the clinical examination 48
Other investigations 55
General comments 57
4 THE SPINAL CORD 59
Introduction 60
Gross anatomy of the spinal cord and vertebral column 60
Functional organization of the spinal cord 61
Spinal cord cell types 63
Receptive fields 64
Somatosensory pathways 65
Blood supply to the spinal cord 71
Damage to the spinal cord 72
Comments on the case history 78
5 PAIN AND ANALGESIA 79
Introduction 80
Nociceptors 81
Pain pathways 82
How does the central nervous system interpret a stimulus as painful? 84
Physiology of pain modulation 86
Pain mechanisms after tissue damage:peripheral and central sensitization 90
Neuropathic pain mechanisms 92
Pharmacology of pain 93
Other approaches to pain management 99
General comments on pain management 104
6 CRANIAL NERVES AND THE BRAINSTEM 105
Introduction 106
Anatomical organization of cranial nerves in the brain 106
Internal organization of the brainstem 107
Reticular formation 109
Blood supply to the brainstem 112
Brainstem reflexes 112
Brainstem lesions 116
Comments on the case history 118
7 THE VISUAL SYSTEM 121
Introduction 122
Structure of the eye 122
Visual pathways 125
Visual field defects 127
Pupillary light reflexes 127
Focusing of light on the retina 127
Control of eye movements 130
Structure and function of the retina 131
Processing of visual information 137
Summary 140
8 HEARING AND BALANCE:THE AUDITORY AND VESTIBULAR SYSTEMS 141
Introduction 142
The auditory system 142
The vestibular system 152
Comments on the case history 158
9 MOTOR SYSTEMS Ⅰ:DESCENDING PATHWAYS AND CEREBELLUM 159
Introduction 160
Skeletal muscle contraction 161
Reflexes 164
Descending pathways 167
Clinical importance of reflexes 172
The cerebellum 175
10 MOTOR SYSTEMS Ⅱ:THE BASAL GANGLIA 181
Introduction 182
The basal ganglia:structure and organization 182
Parkinson's disease 184
Huntington's disease 194
11 STROKE AND HEAD INJURY 199
Introduction 200
Physiological control of cerebral blood flow 200
Blood supply to the brain 201
Venous system 204
Functional anatomy of the cerebral vasculature 205
Angiography 206
Stroke 206
Head injury 219
Comments on the case history 225
12 INFECTION IN THE CENTRAL NERVOUS SYSTEM 227
Introduction 228
Types of infection of the central nervous system 228
The meninges 229
Cerebrospinal fluid production and circulation 230
The blood-brain barrier 232
Meningitis 232
Diagnosis and treatment of meningitis 234
Treatment of meningitis 235
Encephalitis 235
Cerebral abscesses 235
Brain infections in the immunocompromised patient 236
13 EPILEPSY 237
Introduction 238
General description of epilepsy 238
Epidemiology of epilepsy 238
Types of epileptic syndrome 239
Diagnostic investigations of epilepsy 239
Different types of seizure 242
Neurobiology of epilepsy 243
Pharmacological treatment of epilepsy 246
Other treatments for epilepsy 248
Treatment of status epilepticus 249
Social consequences of epilepsy 249
14 DEMENTIA 251
Introduction 252
Causes and diagnosis of dementia 252
Neurobiology of learning and memory 253
Alzheimer's disease 256
Treatment of Alzheimer's disease 261
Other types of dementia 263
General considerations in the management of Alzheimer's disease and other types of dementia 265
15 SCHIZOPHRENIA 267
Introduction 268
Schizophrenia:the clinical diagnosis 268
Aetiology of schizophrenia 271
Neurobiology of schizophrenia 272
Treatment of schizophrenia 275
Comments on the management of schizophrenia and the long-term prognosis 278
Other psychoses and schizophrenia-like syndromes 279
16 DEPRESSION AND ANXIETY 281
Introduction 282
Classification of mood disorders 282
Clinical features of mood disorders 282
Epidemiology of depression and natural evolution of the disease 283
Genetics of mood disorders 283
Neurobiology of depression 286
Treatment of depression 287
Bipolar disorder and its treatment 292
General comments on mood disorders 293
Need for new therapeutic targets 294
Comments on the case history 294
Anxiety disorders 294
Treatment of anxiety disorders 295
Insomnia 297
17 ADDICTION 301
Introduction 302
Addiction and drug misuse:general comments 302
Opiates 302
Cocaine and crack 304
Cannabis 305
Nicotine 307
Alcohol 308
Phencyclidine 309
Amphetamines 310
Ecstasy-or the beginning of agony? 310
Hallucinogens 311
Solvents 311
Neurobiology of addiction 312
Addiction and rehabilitation:general issues 313
Index 315