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The Neurology of the Elderly

      Geriatric medical practice commonly involves neurologic disorders. Changes that frequently accompany normal aging often make investigation and evaluation of these disorders difficult. Hearing loss and cognitive impairment can complicate the elicitation of an adequate history, just as muscle loss or sensory dysfunction can interfere with performance of an accurate neurologic examination. Moreover, elderly patients may have atypical manifestations of various disease states. In a discipline such as neurology, in which meticulous attention to detail is important, physicians can easily become frustrated and confused by the findings in an elderly patient with a neurologic complaint. Because of the difficulty in establishing a diagnosis on the basis of the traditional history and physical examination, many elderly patients are subjected to various diagnostic tests, such as lumbar puncture, electromyography, computed tomography, or, more recently, magnetic resonance imaging, in an attempt to find the cause of their symptoms.
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