Anatomical Focus:
Unlike standard textbooks, it emphasizes gross anatomy and the author's hand-drawn diagrams to explain why specific symptoms occur.
Conclusion
Altered mental status / encephalopathy
Patten provides a masterclass in the motor system. He offers a differential diagnosis based on the distribution of weakness: neurological differential diagnosis john patten pdf top
- Rapidly progressive weakness or bulbar involvement (risk of respiratory failure)
- New severe headache (“worst headache”/thunderclap)
- Acute focal deficits, sudden visual loss, or sudden severe vertigo with brainstem signs
- Fever with meningeal signs or altered consciousness
- Refractory seizures or status epilepticus
- Sudden severe back pain with leg weakness or sphincter disturbance (spinal cord compression)
- SpringerLink: If you have university/hospital access, the PDF is available for download via their "Springer Book Archives."
- Google Books: Often provides snippet view, which includes the famous tables.
- Internet Archive (Non-commercial): Some institutions have digitized their copies for registered patrons.
- Used Book + Scanner: Many top clinicians buy a used paperback ($20-$40) and scan the tables themselves for personal use.
Clinical Logicality
: It emphasizes a "common things are common" approach, focusing first on high-incidence conditions before briefly addressing rare disorders. Rapidly progressive weakness or bulbar involvement (risk of