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Welcome to the second installment of your study of the Nervous System. Faculty members from both clinical and basic science departments have assembled a series of lectures and conferences to provide you with an introduction to disorders of the nervous system. The course will also touch on diagnosis and treatments, but these will be the topics of your clinical years.

The teaching faculty is drawn from the Departments of Anesthesiology, Medicine, Neurology, Neuropathology, Neurosurgery, Pharmacology, Psychiatry, Physiology & Neuroscience, and Radiology. (Please see Faculty & Staff Listing)

Objectives and Specific Aims
The overall objective of the Nervous System Module is to help the students gain the knowledge and confidence necessary to successfully approach neurological problems through an understanding of the scientific foundation of nervous system disease. This will be achieved by: (1) providing an understanding of the basic concepts underlying nervous system disorders; (2) imparting the essential facts of neuropathology, neuroradiology, pathophysiology, psychopathology, and neuropharmacology; and (3) relating these concepts and facts to clinical situations through the study of case histories in small group conferences.

The specific aims of the neuropharmacology topics are to understand the mechanism of action of autonomic and opiate agents, to develop an awareness of the most common and fatal toxicities of these agents and to know common uses of autonomic and opiate agents.

Organization
This is a “topics” course in that not all aspects of nervous system disease will be covered. Diseases and disorders have been chosen that either best illustrate a concept or principal or are commonly seen by non-specialists.

The course has two parts. The first emphasizes topics related to trauma and disease processes, nervous system development, the peripheral nervous system, and sensory systems.

The second part begins with a consideration of pain and pain management, and then emphasizes disorders of the central nervous system to include disorders of movement and cognition.

Related Modules
The content of two modules have been integrated with this one. Physical diagnosis will begin with the nervous system so you will have experience with patients as you study about the nervous system. PPS 2 has a section on pain at the end of the second part of this module. There will be questions on the second exam on this material, but it will be graded separately and combined with your performance on the OSCE for your PPS “Pain” grade.

Lectures, Handouts & Slides
Nervous system lectures are identified on the block schedule as “NS”. This is the second time this course is being given and we will make all the handouts and slides from last year available. Slides shown in lecture will be posted on the web before or immediately after the lecture.

Conferences
Each week throughout the module you will meet in small groups on the psychiatry services for the purpose of interviewing psychiatric patients and writing mental status examinations.". In the second part of the course there will be two case-based neurology conferences. Everyone has been assigned to a conference and interview group and attendance is required. The conferences will provide an informal forum for assessing your understanding of the course material through discussion of clinical problems. Cases are written by the faculty. Additional cases are available in your textbook (see Resources). These have been chosen to complement the lecture material.

Resources
Overall. The primary resources for students in this course are the handouts (lecture and conference), the lecture images as reproduced on the curriculum web site, cases posted on the course website and the following textbook.

Neuroanatomy through Clinical Cases by Hal Blumenfeld, Sinauer Associates, 2002

Psychopathology
The required reading for the psychiatry portion of the course will be from Kaplan and Sadock's Synopsis of Psychiatry, 9th Edition.

Neuropathology
Additional reading for Neuropathology will be found in the appropriate chapters in the Robbins textbook of Pathology. As supplementary material the following text is on reserve in the medical library
Atlas of Clinical Neurology, 2nd Edition by Drs. G. David Perkin, Fred H. Hochberg, and Douglas C. Miller. This book contains many photographs, mostly gross but also some photomicrographs, from Dr Miller's collection, many of which are used in this course. The Atlas will also be available through the course web site.

Neuropharmacology
The following book is recommended for all aspects of pharmacology, including neuropharmacology because it is a comprehensive and useful for obtaining relevant information. When reading this book, direct your attention to a comparison of each of the drugs in the chapter. (The questions on the examinations generally demand the detail found in this book.)

Basic and Clinical Pharmacology, Ninth Edition, by Bertram G. Katzung (a Lange medical book), 2004.

The following are an illustrated guide (1), review (2&3) or reference (4) texts.
1. Pharmacology, second edition, edited by Richard A. Harvey et al., (Lippincott's Illustrated Review), 2000.
2. Pharmacology (Examination and Board Review), seventh edition, by Bertram G. Katzung and Anthony Trevor (a Lange medical book), 2004.
3. Pharmacology Recall by Anand Ramachandran, Lippincott Williams and Wilkins,
4. The Pharmacological Basis of Therapeutics (a.k.a. Goodman and Gilman), tenth edition, edited by Joel D. Hardman et al., McGraw Hill, 2001.

Examinations
There will be two written exams: these will be largely case-based and cover lecture and conference material. The material will be balanced with â 5 points per lecture. The examinations are not cumulative. (Conference 7 will be tested as part of the EBPM Course.)

There will be one OSCE emphasizing the pathophysiology and management of pain, but will include other subjects.

Grading
* 70% is the passing grade for the material on each individual exam and for the course in total.
* Any student receiving a grade of 69% or lower on any exam will be required to take a make-up exam. However, only one make-up will be given.
* Attendance at conferences is required to pass the course.
• The Preclinical Examining Board at its December meeting will determine remediation for anyone who fails the course.

Kerry Walton, PhD
Nervous System Module Director

Myrl Manley, MD
Psychopathology Course Director

Laura Boylan, M.D. & Richard Hanson, M.D.
Neurology Course Directors

Douglas C. Miller, MD, Ph.D.
Neuropathology Course Director

Arnold Stern, MD, PhD
Neuropharmacology Course Director