Neurology

Question 1

Define neurogenic claudication

Answer 1

Pain, heaviness and/or weakness when walking caused by compression of spinal nerves in lumbar spine

Question 2

Characteristic symptoms of neurogenic claudication:

Answer 2

• Pain, tingling or cramping in lower back and one or both legs, hips and buttocks
• Weakness or heaviness in legs
• Symptoms worsen when standing upright or walking
• Symptoms relieved when leaning forward or sitting down

Question 3

Features of BPPV:

Answer 3

• Short, sudden episodes of vertigo triggered by head movements
• Fatiguable nystagmus
• No hearing loss

Question 4

Features of Ménière’s disease:

Answer 4

• Sudden onset of vertigo, tinnitus, and sensation of fullness in the affected ear
• Hearing loss
• Short (<20 mins), recurrent attacks
• Not exacerbated by movement

Question 5

Features of vestibular neuronitis:

Answer 5

• Abrupt onset of severe vertigo, nausea, vomiting and lethargy lasting several days
• No hearing loss or tinnitus
• Exacerbated by movement
• May be preceded by viral illness

Question 6

What disease causes a headache that is worse when bending over?

Answer 6

Sinusitis

Question 7

What could be causing a headache that is worse on standing?

Answer 7

Intracranial hypotension caused by LP or epidural anaesthesia