Tutorial Neurology Part I

By KT :))

Overview
Cortex, subcortex, brainstem, cerebella, cranial nerve Spinal cord Motor neuron dz: tongue atrophy, no ocular, no BB Nerve: sensation, reex, pure motor?? NMJ: uctuation muscle: no sensation, normal reex

Exam
25 yo 1 wk 3 PE: bilateral facial palsy, feet and wrist drop, absent DTR
beriberi polymyositis transverse myelitis MG GBS

Dx?

Pure motor neuropathy

Porphyria Guillain Barre Syndrome Lead Diphtheria

Motor pathway

EXAM

Sensory pathway

Sensory pathway

Exam
65 . Rt internal capsule Lt internal capsule Rt thalamus Lt thalamus

visual pathway

Clue to diagnosis

HOMONYMOUS HEMIANOPIA Optic tract lesion --> incongruous Occipital lobe --> congruous

Clue to diagnosis

HOMONYMOUS QUADRANANOPIA Pie in the sky --> tumor Pie on the oor --> vascular

cortical lobe function

Exam

36 Dx: acute leukemia s/p chemotherapy . PE: BP 180/100 mmHg with right hemianopia.. what is most likelly dx?

Posterior reversible encephalopathy syndrome

causing posterior white matter edema relative hypertension --> autoregulation failure cause: HT, eclampsia, cytotoxic medications

EXAM

Internuclear ophthalmoplegia

One and a half syndrome

WEBINO

wall-eyed bilateral internuclear ophthalmoplegia both medial recti both MLFs

Exam

Syndrome of oculomotor

Exam

Multiple CN: Mimicker

Multiple cranial nerves

Cavernous sinus: II, III, IV, V1, V2 Orbital apex: II, III, IV, VI, V1 Sup orbital ssure: III, IV, VI, V1

Cavernous sinus

Exam board med 2010

65 . 30 seizure vertebrobasilar insufciency c- spondylosis peripheral vertigo

Brainstem stroke

MIDBRAIN: Benidikt, Parinaud, Weber PON: lock-in syndrome Medulla: Wallenberg

Exam
16 PE: impaired vertical gaze, no weakness lm MRI brain: investigation

Exam

Complete cord
Trauma Compression Demyelination Post-infectious

Central cord
syringomyelia tumor hematomyelia demyelination

Hemicord

Trauma Demyelination compression

Ant cord
Ant spinal artery ischemia post surgery cardiac arrest

Vulnerable area: T6

Exam
45 PE: mod pale, no jaundice, CLN -ve, Motor- grade IV/III, decreased propioception both sides Tabes dorsalis syringomyelia metastatic bone disease B12 deciency

Subacute combined degen

Treatment B12 1000 ug daily IM * 5 days the B12 1000 ug PO OD indenitely

Transverse myelopathy
vascular infection autoimmune demyelinating disease Treatment: transverse myelitis--> high dose steroid MS --> pulse methylpred

Exam
44 2 7 2 c-spondylosis amyotrophic lateral sclerosis CIDP syringomyelia

Syringomyelia

Mononeuropathy
carpal tunnel syndrome wrist drop foot drop lateral femoral cutaneous nerve

Exam

lateral cutaneous nerve of thigh common peroneal nerve deep peroneal nerve

Exam
30 yo male, nerve
median nerve radial nerve ulnar nerve posterior interosseous nerve

EXAM

Meralgia paresthetica

Demyelinating dz
CNS PNS

acute ADEM

chronic MS

acute GBS

chronic CIDP

EXAM

Spot diagnosis for board exam