Lower limb Neurology

Question 1

Features of femoral nerve lesion

L2-4

Answer 1

Weakness of knee extension
Slight hip flexion weakness
Preserved adductor strength
Loss of knee jerk
Sensory loss to inner aspect of thigh and leg

Question 2

Features of a Sciatic nerve lesion?

L4-S2

Answer 2

Weakness of knee flexion
Loss of power below the knee
Loss of ankle jerk and plantar response
Sensory loss on posterior thigh and below the knee

Question 3

Features of a common peroneal nerve lesion?

L4-S1

Answer 3

Foot drop and eversion loss
Minimal sensory loss
Normal reflexes

Question 4

Cause of foot drop?

Answer 4

Common peroneal nerve palsy
Sciatic nerve palsy
Lumbosacral plexus injury
L4 or L5 root lesion
Peripheral motor neuropathy
Distal myopathy
MND
Precentral gyrus lesion

Question 5

Causes of a sensory level on a paraplegic patient?

Answer 5

Cord compression
Transverse myelitis
Multiple sclerosis
Anterior spinal artery occlusion
Intrinsic cord lesions

Question 6

Arm involvement in a paraplegic patient?

Answer 6

Cervical spondylosis
Syringomyelia
MND
Multiple sclerosis

Question 7

Cranial nerve lesions in paraplegia?

Answer 7

MND

Multiple sclerosis

Question 8

Peripheral neuropathy in paraplegia?

Answer 8

Vitamin B12 Deficiency
Freidrech's ataxia
Carcinoma
Hereditary spastic paraplegia
Syphilis

Question 9

Features of subacute degeneration of the cord?

Answer 9

Symmetrical posterior column loss –> ataxic gait
Symmetrical UMN signs in the legs with absent ankle +/- knee jerks
Peripheral sensory neuropathy
Optic atrophy and dementia

Question 10

Features of Brown - Sequard syndrome

Answer 10

Motor - SAME SIDE AS LESION LMN signs at the level of the lesion and UMN signs below the level of the lesion
Sensory - OPPOSITE side loss of pain and temperature below the level of the lesion
SAME side vibration and proprioception loss

Question 11

Causes of Brown- sequard syndrome?

Answer 11

MS
Trauma
Angioma
Glioma
Myelitis
Post-radiation

Question 12

Features of syringomyelia?

Answer 12

Loss of pain and temperature over neck, shoulders and arms
LMN signs on arms - Weakness, atrophy and areflexia
UMN signs in legs

Question 13

Typical gaits?

Answer 13

Hemipareitc
Paraparetic
Extrapyramidal/Parkinsonian
Cerebellar
Apraxic
Slapping feet of Peripheral neuropathy
Distal weakness --> high stepping
Proximal weakness - waddling gait