Clinical medicine rotations
Neurology
Neurology is the medical specialty of the brain, spinal cord, nerves and muscles. It is the closest clinical neighbour of psychiatry: epilepsy, stroke, dementia, Parkinson's disease and multiple sclerosis all commonly cause psychiatric symptoms.
Depth by stage, Pre-U → Consultant (details)
What is it?
Neurology covers diseases of the nervous system: stroke, epilepsy, headache, Parkinson's disease, multiple sclerosis, dementia, nerve and muscle diseases and brain infections. Students learn the neurological examination and how to work out where in the nervous system a problem lies.
In some universities neurology is taught within internal medicine; in others it has its own short posting. Students learn to read brain scan reports and understand tests such as EEG and nerve conduction studies.
The boundary between neurology and psychiatry is not sharp. The same brain disease can cause weakness and depression, or seizures and psychosis.
Why does a psychiatrist need it?
Psychiatrists must recognise neurological causes of psychiatric symptoms, such as frontal lobe tumours causing personality change or encephalitis presenting as psychosis. They also manage depression after stroke, psychosis in Parkinson's disease, dementia-related behaviour problems and functional neurological disorder.
What level is expected at each stage?
Scale: 1. Aware → 2. Understands → 3. Applies → 4. Masters / Teaches. What the levels mean.
- Pre-UNot expected
- Pre-clinicalAwareLearns neuroanatomy and neurophysiology in basic form.
- ClinicalUnderstandsPerforms a neurological examination and recognises common neurological diseases.
- HousemanshipUnderstandsManages stroke, seizures and neurological emergencies on medical postings.
- Medical officerUnderstandsRecognises neurological causes of mental symptoms.
- Psych traineeAppliesApplies neurology in neuropsychiatry, old age and liaison work; tested in MMed Part I and MRCPsych papers.
- Specialist / consultantAppliesCollaborates with neurologists on complex neuropsychiatric cases.
What are the key topics?
Neurological examination
- Cranial nerves, motor and sensory systems
- Reflexes, coordination and gait
- Localising a lesion
- Cognitive screening at the bedside
Common conditions
- Stroke and transient ischaemic attack
- Epilepsy and seizure types
- Headache and migraine
- Parkinson's disease and movement disorders
- Multiple sclerosis
- Dementias: Alzheimer's, vascular, Lewy body, frontotemporal
- Brain infections: meningitis, encephalitis
Investigations
- CT and MRI brain
- EEG
- Lumbar puncture
- Nerve conduction studies
Links to psychiatry
- Depression after stroke
- Psychosis and depression in epilepsy
- Psychiatric symptoms of Parkinson's disease and its treatment
- Autoimmune encephalitis presenting as psychosis
- Functional neurological disorder
- Drug-induced movement disorders from antipsychotics
How is it learned and assessed?
- Neurology clinics and ward rounds
- Neurological examination practice and OSCE stations
- Assessed within medicine or a separate posting
- Revisited in psychiatry training through neuroscience and neuropsychiatry topics
Typical textbooks and resources
- Neurology and Neurosurgery Illustrated (Lindsay and Bone) — visual student text
- Oxford Handbook of Neurology — practical reference
- Lishman's Organic Psychiatry — the classic text linking neurology and psychiatry
- Neurological examination guides (e.g. Neurological Examination Made Easy, Fuller)
Titles are widely used examples; editions change. Use university libraries or legitimate purchases.
Common questions
What is the difference between a neurologist and a psychiatrist?
A neurologist treats diseases of the nervous system such as stroke and epilepsy. A psychiatrist treats mental disorders affecting mood, thinking and behaviour. They overlap in conditions like dementia and epilepsy with psychiatric symptoms.
Can brain diseases cause mental illness?
Yes. Stroke, tumours, infections, epilepsy and dementia can all cause depression, anxiety, psychosis or personality change. Psychiatrists are trained to look for these causes.