Introduction

Some internal medicine residents see neurology patients while rotating on an inpatient neurology service, and most care for patients on the medical ward who develop neurologic issues such as acute stroke or seizure. This rotation guide addresses the key neurologic issues you will likely see, regardless of rotation, as an internal medicine resident. This rotation guide focuses on urgent neurologic problems affecting inpatients, so topics such as multiple sclerosis and Parkinson’s disease are not covered.

This rotation guide covers the following topics:

Management of Acute Stroke
Carotid Stenosis
Meningitis and Encephalitis (Infections of the Central Nervous System)
Epidural Abscess and Vertebral Osteomyelitis
Seizures and Epilepsy
Targeted Temperature Management (TTM)
Altered Mental Status
Headache

Other relevant topics in Neurology are covered in the following rotation guides:

Dizziness (Ambulatory Care)
ICU Delirium (Critical Care)
Dementia, Delirium (Geriatrics)
Metastatic Spinal Cord Compression and Brain Metastases (Oncology)

John Probasco, MD, is an Assistant Professor of Neurology in the Johns Hopkins Department of Neurology where he cares for general neurology inpatients and serves as Medical Director of the Inpatient General Neurology Service.

This rotation guide was developed by a collaborative team of contributors, including:
Writers: Krista Nottage, MBBS; Andrea Merrill, MD; Rebecca Berger, MD (NEJM Fellows)
Peer Reviewers: David Lin, MD; Michael Erkkinen, MD; and Saad Mir, MD
Section Experts: John Probasco, MD and S. Andrew Josephson, MD
Senior Editor: Ole-Petter Hamnvik, MB BCh BAO, MMSc
Last Updated: February 2023, by John Probasco, MD