GEMC:Nervous System Disorders

General

This the main page for the Global Emergency Medicine Curriculum Project's Nervous System Disorders section. For point of care treatment information see the respective category page and non-GEMC notes.

Headache

Policies and Guidelines

• American College of Emergency Physicians Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department with Acute Headache https://www.acep.org/Clinical---Practice-Management/Clinical-Policy--Critical-Issues-in-the-Evaluation-and-Management-of-Adult-Patients-Presenting-to-the-Emergency-Department-with-Acute-Headache/
• AHRQ Acute Migraine Treatment in Emergency Settings. Comparative Effectiveness Review #84. ../docss/TOC.pdf Accessed Aug 2013.

Seizure Disorders

Blogs and Websites

• Status Epilepticus (Which Benzo to use?) http://emnerd.com/adventure-dancing-men/

Policies and Guidelines

• American College of Emergency Physicians Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department With Seizures https://www.acep.org/Clinical---Practice-Management/Clinical-Policy--Critical-Issues-in-the-Evaluation-and-Management-of-Adult-Patients-Presenting-to-the-Emergency-Department-With-Seizures/

Stroke and TIA

Journal Articles - Open Access

• Saver JL, Fonarow GC, Smith EE, et al. Time to treatment with intravenous tissue plasminogen activator and outcome from acute ischemic stroke. JAMA. 2013 Jun 19;309(23): 2480-8.
• Hacke W, Donnan G, Fieschi C, et al. Association of outcome with early stroke treatment: pooled analysis of ATLANTIS, ECASS, and NINDS rt-PA stroke trials. Lancet. 2004 Mar 6; 363(9411): 768-74.
• Lees KR, Bluhmki E, von Kummer R, et al. Time to treatment with intravenous alteplase and outcome in stroke: an updated pooled analysis of ECASS, ATLANTIS, NINDS, and EPITHET trials. Lancet. 2010 May 15; 375(9727): 1695-703.
• Hoffman JR, Schriger DL. A graphic reanalysis of the NINDS Trial. Ann Emerg Med. 2009 Sep;54(3):329-36, 336.e1-35.
• Wardlaw JM, Murray V, Berge E, Del Zoppo GJ. Thrombolysis for acute ischaemic stroke. Cochrane Database Syst Rev. 2009 Oct 7;(4):CD000213.
• Wardlaw JM, Koumellis P, Liu M. Thrombolysis (different doses, routes of administration and agents) for acute ischaemic stroke. Cochrane Database Syst Rev. 2013 May 31;5:CD000514.
• Sandercock P, Wardlaw JM, Lindley RI, et al. The benefits and harms of intravenous thrombolysis with recombinant tissue plasminogen activator within 6 h of acute ischaemic stroke (the third international stroke trial [IST-3]): a randomised controlled trial. Lancet. 2012 Jun 23; 379(9834): 2352-63.
• American College of Emergency Physicians; American Academy of Neurology. Clinical Policy: Use of intravenous tPA for the management of acute ischemic stroke in the emergency department. Ann Emerg Med. 2013 Feb;61(2):225-43.
• Lenzer J. Why we can't trust clinical guidelines. BMJ. 2013 Jun 14;346:f3830. doi:10.1136/bmj.f3830.

Blogs and Websites

• Henry R. Black, MD. Rapid BP Lowering in Acute Intracerebral Hemorrhage: Risky? http://www.medscape.com/viewarticle/809753 Accessed Aug 2013

Policies and Guidelines

• American College of Emergency Physicians Clinical Policy: Use of Intravenous tPA for the Management of Acute Ischemic Stroke in the Emergency Department https://www.acep.org/Clinical---Practice-Management/Clinical-Policy--Use-of-Intravenous-tPA-for-the-Management-of-Acute-Ischemic-Stroke-in-the-Emergency-Department/

Podcasts

• Newman, David. Scientific Medicine And Research Translation in Emergency Medicine (SMART-EM) Website. SMART Thrombolytics for Stroke: Update. Published 12 Aug 2013. http://smartem.org/podcasts/smart-thrombolytics-stroke-update Accessed Aug 2013.

See Also

• GEMC: Global Emergency Medicine Curriculum (Main)

Authors

Joe Lex, Ross Donaldson, Michael Holtz, Daniel Ostermayer