Dizziness, vertigo

Question 1

How is diagnosis of BPPV established?

Answer 1

Characteristic vertical and torsional nystagmus with Dix Hallpike maneuver

Question 2

Describe examples of neurogenic syncope

Answer 2

Micturition syncope, carotid sinus hypersensitivity ( carotid sinus compression), Neurocardigenic (contraction of an unfolded ventricle), vasovagal syncope

Question 3

How do lesions of the vermis differ from lesions of the hemispheres?

Answer 3

Vermis lesions cause truncal ataxia

Hemispheric lesions cause ipsilateral limb ataxia

Question 4

What part of cerebellum bears the brunt of damage in alcoholic cerebellum degeneration?

Answer 4

Vermis - causes trunk and gait ataxia

Question 5

What population tends to be affected by post infectious cerebellitis? How do they present?

Answer 5

Young kids - present with ataxia and dysarthria

Question 6

What types of cancers are associated with cerebellum degeneration?

Answer 6

Gynecological cancer, small cell lung cancer

Question 7

When is the onset of friedrichs ataxia?

Answer 7

Childhood

Question 8

What is the typical presentation of friedrich ataxia?

Answer 8

Progressive ataxia of arms more than legs, loss of reflexes, spasticity, impaired vibration and position sense

Question 9

What is the pathophysiology of EA2

Answer 9

Mutation in voltage gated calcium channel

Question 10

A young patient presents with ataxia and moderate progressive cogn time decline. This is…

Answer 10

Spinocerebellar ataxia

Question 11

A patient presents wtih ataxia, areflexia and opthalmolplegia following a course of illness. What is this and what is the pathophysiology?

Answer 11

Miller Fishcer syndrome - ataxia due to loss of propioception

Question 12

A patient presents with slow shuffling gait with limited movement of arms and rapid small steps are needed to propulse forward. This is likely..

Answer 12

Parkinsons

Question 13

Describe a frontal gait

Answer 13

difficulty in lifting feet off the ground

Question 14

What is the typical cause of a waddling gait?

Answer 14

weakness of abductor muscles

Question 15

A patient presents wtih a wide based gait that is slow and the forefoot slaps the ground. This is likely a …

Answer 15

sensory ataxia

Question 16

A patient presents with difficulty hearing in the left ear and has experienced high pitched ringing. MRI shows contrast enhancing mass. This is..

Answer 16

acoustic schwannoma

Question 17

35 year old woman has SOB, diaphoresis, feelings of the world closing in. This is..

Answer 17

hyperventilation

Question 18

45 year old female develops dizziness, dysarthria over 10 days. She is unable to sit up without assistance. This is..

Answer 18

paraneoplastic

Question 19

55 year old man complains of unsteadiness and lightheadedness. He has a mild resting tremor, cogwheeling of upper limbs. He has postural hypotension and profound constipation. This is..

Answer 19

parkinsonian plus syndrome - multiple system atrophy

Question 20

83 year old woman has become progressively forgetful, stopped driving. She fails to recognize friends, has become withdrawn. MRI shows cortical atrophy and diffuse enlargement of ventricles.

Answer 20

hydrocephalus ex vacuo

Question 21

57 year od man has progressive difficulty walking, frontal headache. He has spasticity of the legs and hyperactive reflexes with bilateral babinskis. Sensory exam is normal. This is..

Answer 21

parasagittal meningioma

Question 22

A man’s MRI shows enlarged ventricles on MRI with normal 4th ventricle. This is..

Answer 22

aquaductal stenosis

Question 23

A woman with a hx of cervical cancer develops headaches and unsteadiness that worsen with lying down and is accompanied by diplopia and nausea. This is..

Answer 23

obstructive hydrocephalus

Question 24

A 17 year old girl develops morning headaches, nausea and is becoming unsteady on her feet. She has left facial wekaness and left limb dysmetria. This is…

Answer 24

medulloblastoma

Question 25

A patient develops an inability to speak and right sided weakness after seeing her father in the ICU

Answer 25

Conversion