Internal Environment Disorders in Neurology

Internal Medicine · Clinical Specialties

How it begins

El sistema nervioso central y periférico exhibe una sensibilidad exquisita y diferencial hacia las alteraciones del medio interno. Esta vulnerabilidad especial es consecuencia de múltiples factores: la alta demanda metabólica del tejido neural (el cerebro representa el 2% de la masa corporal pero consume el 20% del oxígeno y 25% de la glucosa), la existencia de la barrera hematoencefálica (BHE) con sus propiedades…

What it covers

1. Body Water Compartments and their Neurological Relevance
2. The Cerebrospinal Fluid and the Brain Interstitial Space
3. General Mechanisms of Neurological Dysfunction in Internal Environment Disorders
4. Regulation of Brain Volume
5. · Volume Decrease Regulation (RVD — Regulatory Volume Decrease)
6. · Regulatory Volume Increase (RVI — Regulatory Volume Increase)
7. Intracranial Pressure and Monroe-Kellie Mechanism
8. Hyponatremia — [Na⁺] < 135 mEq/L
9. · Pathophysiology of Cerebral Edema in Hyponatremia
10. · Etiological Classification
11. · Neurological Manifestations of Hyponatremia
12. · Treatment of Hyponatremia with Neurological Manifestations
13. Hypernatremia — [Na⁺] > 145 mEq/L
14. · Pathophysiology of Neurological Dysfunction
15. · Etiology
16. · Neurological Manifestations
17. Hypokalemia — [K⁺] < 3.5 mEq/L
18. · Pathophysiology of Neuromuscular Manifestations
19. · Hypokalemic Periodic Paralysis
20. · Central Nervous System in Hypokalemia
21. Hyperkalemia — [K⁺] > 5.5 mEq/L
22. · Neuromuscular Physiopathology
23. Role of Calcium in Neuronal Function
24. Hypocalcemia — Ionized Ca < 1.15 mmol/L
25. · Mechanism of Neuromuscular Hyperexcitability
26. · Neurological and Neuromuscular Manifestations
27. · Classic Signs of Tetania
28. · Epileptic seizures due to hypocalcemia
29. · Calcification of the Basal Ganglia (Fahr Syndrome)
30. · Hypocalcemia in the Context of Neurological Pathology
31. Hypercalcemia — Total Ca > 10.5 mg/dL
32. · Mechanisms of Neurological Dysfunction
33. · Neurological Manifestations of Hypercalcemia
34. Hypomagnesemia — Mg²⁺ < 1.7 mg/dL
35. · Etiology
36. · Neurological Manifestations
37. · Magnesium in Neurological Treatment
38. Hypermagnesemia — Mg²⁺ > 2.3 mg/dL
39. Hypophosphatemia — Phosphorus < 2.5 mg/dL
40. · Pathophysiology of Neurological Manifestations
41. · Causes of Hypophosphatemia in Neurology
42. · Encephalopathy due to Hypophosphatemia
43. Hyperphosphatemia — Phosphorus > 4.5 mg/dL
44. Mechanisms of Hypercapnic Encephalopathy (CO₂ narcosis)
45. · Clinical Manifestations by PaCO₂ Range
46. · Asterixis in Hypercapnic Encephalopathy
47. Neurological Causes of Respiratory Alkalosis
48. Mechanisms of Neurological Dysfunction in Respiratory Alkalosis
49. Central Neurogenic Hyperventilation
50. Neurological Manifestations by Type of Metabolic Acidosis
51. · Lactic acidosis
52. · Diabetic Ketoacidosis and Diabetic Coma
53. · Intoxications with High AG and Specific Neurological Manifestations
54. Hypoglycemia — Blood glucose < 70 mg/dL
55. · Neuroglycopenia: Pathophysiology
56. · Clinical Sequence of Progressive Hypoglycemia
57. · Hypoglycemia as a Stroke Simulator
58. Hyperglycemia and Hyperosmolar Syndrome
59. · Hyperosmolar Hyperglycemic State (HHS)
60. · Hyperglycemia in Stroke and TBI
61. SIADH Diagnostic Criteria (modified Bartter-Schwartz)
62. Neurological Causes of SIADH
63. · Pathophysiology of SIADH in CNS Pathology
64. · Hyponatremia due to SIADH in Subarachnoid Hemorrhage
65. · Treatment of Chronic SIADH
66. Physiopathology
67. Differences with SIADH — Crucial Differential Diagnosis
68. Neurological and Neurosurgical Causes
69. Post-Neurosurgical Triphasic Pattern
70. Diagnosis
71. · Treatment
72. Physiopathology
73. Clinical Manifestations
74. Diagnostic Imaging
75. Prognosis and Treatment
76. Emergency Evaluation: Basic Metabolic Panel
77. Secondary Diagnostic Levels (as suspected)
78. Principle 1 — Speed of Correction Proportional to Chronicity
79. Principle 2 — Treat the Underlying Cause
80. Principle 3 — Close and Frequent Monitoring
81. Principle 4 — Interactions between Disorders
82. Summary of Correction Objectives
83. Final Integrator Message