High Yield Neurology Shorts

Question 1

Causes of foot drop (8)

Answer 1

1. Common peroneal nerve palsy (preserved ankle jerk)
2. Sciatic nerve palsy
3. Lumbosacral plexus lesion
4. L4, L5 root lesion
5. Peripheral motor neuropathy
6. Distal myopathy
7. Motor neurone disease (increased ankle jerk)
8. Precentral gyrus lesion (increased ankle jerk)

Question 2

Causes of myopathy (10)

Answer 2

1. Hereditary muscular dystrophy
2. Congenital myopathies

mnemonic - PACE PODS

3. Polymyositis or dermatomyositis
4. Alcohol
5. Carcinoma
6. Endocrine
7. Periodic paralysis
8. Osteomalacia
9. Drugs (clofibrate, chloroquine, steroids)
10. Sarcoidosis

Question 3

Causes of unilateral cerebellar disease (5)

Answer 3

1. Space occupying lesion (tumour, abscess, granuloma)
2. Ischaemia (vertebrobasilar disease)
3. Paraneoplastic syndrome
4. Multiple sclerosis
5. Trauma

Question 4

Causes of bilateral cerebellar disease (9)

Answer 4

1. Drugs (eg. phenytoin)
2. Friedreich’s ataxia
3. Hypothyroidism
4. Paraneoplastic syndrome
5. Multiple sclerosis
6. Trauma (punch drunk)
7. Arnold-Chiari malformation
8. Alcohol (most common) - can also cause rostral vermis lesion
9. Large space-occupying lesion, cerebrovascular disease, rare metabolic diseases

Question 5

Causes of Parkinsonism (9)

Answer 5

1. Idiopathic Parkinson’s disease
2. Drugs - eg. phenothiazines, methyldopa
3. Postencephalitis
4. Toxins (carbon monoxide, manganese)
5. Wilson’s disease
6. PSP
7. MSA
8. Syphilis
9. Tumour

Question 6

Causes of peripheral neuropathy (mixed) (9)

Answer 6

1. Drugs and toxins
2. Alcohol, amyloidosis
3. Metabolic - diabetes mellitus (30%), uraemia, hypothyroidism, porphyria
4. Immune related - GBS
5. Tumour - lung carcinoma
6. Vitamin B12 or B1 deficiency, B6 excess
7. Idiopathic (30%)
8. Connective tissue disease - SLE, PAN
9. Hereditary (30%)

Question 7

Causes of peripheral neuropathy (motor predominant) (6)

Answer 7

1. Guillain-Barre syndrome, CIDP
2. Hereditary motor and sensory neuropathy (Charcot-Marie-Tooth)
3. Acute intermittent porphyria
4. Diabetes mellitus
5. Lead poisoning
6. Multifocal motor neuropathy

Question 8

Causes of peripheral neuropathy (sensory predominant) (8)

Usually associated with sensory ataxia and pseudoathetosis

Answer 8

1. Diabetes mellitus
2. Carcinoma (eg. lung, ovary, breast) (may be neuronopathy, length independent)
3. Paraproteinaemia
4. Vitamin B6 intoxication
5. Sjogren’s syndrome (often a neuronopathy)
6. Syphilis
7. Vitamin B12 deficiency (occasionally)
8. Idiopathic

Question 9

Causes of a painful peripheral neuropathy (7)

Answer 9

1. Diabetes mellitus
2. Alcohol
3. Vitamin B12 or B1 deficiency
4. Carcinoma
5. Porphyria
6. Arsenic or thallium poisoning
7. Hereditary (most are not painful)