Welcome to this week’s edition of EMin5 by Dr. Anna Pickens.  Today we’ll review a few tips on how to do a rapid neurology exam of the hand, and the great thing is you can complete the whole thing with one swift motion!

Clay brings you managing severe hypertension, guidelines on nonvariceal upper GI bleeding, and AHA stroke guideline updates.

Our wrap-up this week covers febrile seizure, duration of antibiotic therapy for strep throat, fluid bolus before intubation, and the 2019 ACEP policy on acute headaches.

Chuck brings a tough case of cauda equina syndrome in this month's Medical Malpractice Insights.

What should you do with the critically ill patient with meningitis?

A 29-year-old female presents with generalized weakness and vision problems. The weakness is worse at the end of the day, and she has noted double vision. The symptoms worsen with heat. She denies any other neurologic deficits, including paresthesias. What is the likely diagnosis, and what is your next step in evaluation?

Jonas Pologe is back with the EM Beats by Doge series. Today, Dr. Pologe brings you serious headaches.

A 33-year-old female presents with blurry vision. She has also experienced intermittent paresthesias in her extremities and weakness. Your motor and sensory exam is normal, but you find internuclear ophthalmoplegia and an afferent pupillary defect. With these intermittent neurologic symptoms and ocular findings, what is the likely diagnosis, and what is your next step in evaluation?