Neurolocalisation

Question 1

What is Horner Syndrome, and what are its classic symptoms?

Answer 1

Horner Syndrome is a condition caused by disruption of the sympathetic nerves to the eye, characterized by ptosis (droopy eyelid), miosis (small pupil), and sometimes anhidrosis (lack of sweating)​

Question 2

What are the clinical findings in a T1 root or lower brachial plexus lesion?

Answer 2

Findings include ptosis, miosis, anhidrosis, wasting in the 1st interosseus space, weakness of finger extension and abduction, and sensory loss in the forearm​

Question 3

Describe the three sensory inputs essential for balance.

Answer 3

Balance relies on proprioception, vision, and vestibular input. If one is compromised (e.g., proprioception), two others are needed to maintain balance

Question 4

What is the Romberg test, and what does a positive result indicate?

Answer 4

The Romberg test assesses balance by having a person stand with eyes closed. A positive Romberg sign indicates a problem with proprioception or vestibular function​

Question 5

What is Guillain-Barré Syndrome (GBS), and what are its hallmark features?

Answer 5

GBS is a post-infectious, often ascending peripheral neuropathy that presents with numbness, absent reflexes, and weakness. It can lead to respiratory failure and arrhythmias if severe​

Question 6

How is voluntary gaze controlled, and what structure mediates this?

Answer 6

Voluntary gaze is initiated in the frontal eye fields and mediated by the paramedian pontine reticular formation (PPRF) in the pons, coordinating lateral gaze​

Question 7

What is internuclear ophthalmoplegia (INO), and what causes it?

Answer 7

INO is a failure of eye adduction on lateral gaze, often due to a lesion in the medial longitudinal fasciculus (MLF) between the pons and midbrain​

Question 8

: What are some causes of dorsal column involvement leading to proprioception and vibration loss?

Answer 8

Conditions affecting the dorsal column include B12 deficiency, syphilis, and copper deficiency​

Question 9

In which conditions might we see absent reflexes with no upper motor neuron (UMN) signs?

Answer 9

Absent reflexes with no UMN signs typically indicate peripheral nervous system pathology, such as Guillain-Barré Syndrome​

Question 10

Why do patients with Guillain-Barré Syndrome often not exhibit muscle wasting despite lower motor neuron signs?

Answer 10

In GBS, muscle wasting is typically absent due to the acute nature of the demyelinating process before significant atrophy occurs​