Condition Identification

Question 1

After viral illness

Asymmetric flaccid weakness

Absent reflexes

Bowel and bladder dysfunction

Answer 1

Acute flaccid paralysis (can be caused by West Nile virus

Question 2

Fatal disease
Tongue weakness
Upper motor neuron and lower motor neuron degeneration

Answer 2

ALS

Question 3

Gradual or sudden onset of progressive and persistent muscle weakness/fatigue

Lower motor neuron syndrome

Symptoms for 1+ year

Answer 3

If they previously had polio: Post polio syndrome

Question 4

Length dependent
Commonly Symmetric
Loss of DTR
Stocking and glove distribution

Answer 4

Polyneuropathy

Note: hundreds of causes

Question 5

Orthostatic hypotension

Arrhythmia

Urinary retention

Constipation

Abnormal sweating

Answer 5

Autonomic neuropathy

Question 6

Neuropathic pain
Autonomic dysfunction
Inability to feel pain or temp

Answer 6

Small fiber neuropathy

Question 7

Paresthesias > severe radicular back pain > weakness

Facial weakness
Symmetric weakness
Areflexia

Progresses over course of 1 month, will recover naturally

Answer 7

ADIP/ Guillane Barre Syndrome

Question 8

Mostly Relapsing-remittent

Proximal and distal symmetric weakness —-> atrophy

Hyporeflexic or areflexic

Slowly progresses over weeks to months

Answer 8

Chronic inflammatory demyelination polyneuropathy

Question 9

Sharp or aching pain asymmetrically in hip and thigh, spreads to leg and foot

Pain -> weakness in proximal LE -> weakness progresses distally

Answer 9

Diabetic lumbosacral radiculoplexus neuropathy

Question 10

Distal weakness and atrophy

Length dependent sensory loss

Absent/decreased reflexes

Onset before 20

Foot deformities

Answer 10

Hereditary motor and sensory neuropathy (Charcot Marie tooth disease)

Question 11

Autoimmune disorder
Younger woman and older men
Easily Fatiguable
Gets better with rest
Ptosis, dysphasia, diplopia, dysarthria,
Weakness

Answer 11

Myasthenia Gravis

Question 12

Proximal weakness
Sensation intact
DTR can be normal or slightly reduced

Answer 12

Myopathy

Question 13

Subacute/chronic onset of proximal weakness

Variable pulmonary/cardiac involvement

May be related to malignancy, auto immune disorder, or HIV

Answer 13

Polymyositis or dermatomyositis

Question 14

Proximal leg and distal arm weakness (quads and fingers)
Asymmetric
Muscle atrophy
Dysphasia
Most frequent myopathy In patients over 50

Answer 14

Inclusion body myositis

Question 15

Progressive muscle weakness and atrophy

Prolonged muscle contractions

Unable to relax certain muscles

Genetic

Answer 15

Myotonic dystrophy type 1

Question 16

Atrophy and weakness of facial and shoulder muscles

Answer 16

Facioscapulohumeral dystrophy

Question 17

weakness of ocular and throat muscles

Genetic

Answer 17

Oculipharyngeal muscular dystrophy

Question 18

Genetic, usually happens in young people

Progressive weakness and stiffness in shoulder and upper arms

Answer 18

Emery Dreifuss Muscular dystrophy

Question 19

Commonly follows infection or vaccine
Mostly affects children
Bilateral symmetric inflammatory changes on brain MRI
Usually Monophasic

Answer 19

Acute disseminated encephalomyelitis

ADEM

Question 20

Acute spinal cord dysfunction

Back pain, sphincter dysfunction, paraparesis

Maybe first episode of MS

MRI shows 2 different vertebral segments with inflammation

Answer 20

Acute transverse myelitis

Question 21

Pain w/ eye movement

Acute onset of visual problems

Loss of color

Unilateral swollen optic disc

Afferent pupillary defect

Answer 21

Optic neuritis

Question 22

Patient had optic neuritis, then at a later point had transverse myelitis

Answer 22

Likely multiple sclerosis due to separation of space and time

Question 23

Leading cause of non traumatic disability
Higher rates in north
Affects all systems of body
Pt has had 2 separate instances of auto immune problems with their nervous system

Answer 23

Multiple sclerosis

Question 24

Can be relapsing remittent, or progressive

Exact cause unknown

Reduces life expectancy 7 to 14 years

First flare up can look like optic neuritis or transverse myelitis

Answer 24

Multiple sclerosis

Question 25

UMN spastic weakness

Ataxia, tremor, scanning speech

Spinothalamic lesions

Llhermites phenomenon- electric sensation passing down the back and limbs w/ neck flexion

Trigeminal neuralgia

Cognitive problems

Fatigue

Newer medications work better but come with more risk of infection due to immunosuppressive

Answer 25

Multiple sclerosis

Question 26

Patient is on immunosuppressant drugs

Disease comes from infection that is
Asymptomatic in 86% of the population

Usually fatal in one year if not caught

Can mimic a MS attack

Answer 26

Progressive multi focal leukoencephalopathy PML

Question 27

Transverse myelitis + optic neuritis (often bilateral)

Pt presents with transverse myelinitis lesions in over 3 vertebral levels

More severe than MS

Answer 27

neuromyelitis optica

Question 28

Usually affects young children
Monophasic
Presents like MS (optic neuritis, transverse myelitis)

similar to acute disseminated encephalomyelitis

Good recovery prognosis

Answer 28

Myelin oligodendrocyte glycoprotein antibody disease (MOG)

Question 29

Chronic alcoholics

Wide base of support

Ataxic gait (little ataxia with heel to shin test)

Arm coordination is still good

Sometimes nystagmus, hypotonia, dysarthria

Answer 29

Rostral vermis syndrome

Question 30

Typically in children w/ medulloblastoma

Little or no limb ataxia

Axial disequilibrium and staggering gait

Spontaneous nystagmus and rotated head postures

Answer 30

Caudal vermis syndrome

Question 31

D/t infarcts, tumors, abscess

Incoordination/ ataxia w/ ipsilateral movement, especially those that require fine motor control

Answer 31

Cerebellar hemispheric syndrome

Question 32

Caused by infections, hypoglycemia, hyperthermia, paraneoplastic, hereditary

Bilateral Cerebellar signs affecting limbs, trunk, and cranial musculature

Answer 32

Pancerebellar syndrome

Question 33

Ataxia in young children

Loss of ability to ambulate after 10-15 years

Foot deformities

Areflexia

Scoliosis

Sensory loss

Genetic

Answer 33

Friedreich ataxia