Neurology

Question 1

Causes of cerebellar syndrome

Answer 1

• MS
• Alcohol
• Paraneoplastic
• Stroke
• Space-occupying lesion
• Cerebellarpontine angle lesion → NF2
• Lateral medullary syndrome
• Multiple system atrophy

Question 2

Causes of flaccid paralysis

Answer 2

Anterior horn cell → muscle

• MND
• Poliomyelitis
• Space-occupying lesion → abscess, tumour, haematoma, disc prolapse
• Nerve damage → trauma, surgery
• Mononeuritis multiplex
• GBS / CIDP
• Neuromuscular junction disorders
• Myopathies

Spine → muscle

Question 3

Causes of hemiparesis

Answer 3

• Vascular → intracranial haemorrhage & infarct
• Space-occupying lesion → tumour, subarachnoid haemorrhage & abscess
• Cerebral palsy
• Migraine
• Todd’s paresis
• Hypoglycaemia
• Sepsis

Question 4

Causes of Horner’s syndrome (1st order)

Answer 4

Central (anhydrosis of face, arm & trunk involvement):
* Stroke
* SOL
* MS
* Syringomyelia

Question 5

Causes of Horner’s syndrome (2nd order)

Answer 5

Pre-ganglionic (anhydrosis of face):
* Pancoast tumour
* Trauma
* Thyroidectomy
* Cervical rib
* Cervical lymphadenopathy

Question 6

Causes of Horner’s syndrome (3rd order)

Answer 6

Post-ganglionic (no anhydrosis)
* Carotid aneurysm & dissection
* Cluster headache
* Orbital tumour

Question 7

Causes of peripheral neuropathy

Answer 7

• Alcohol (B)
• B1 & B12 deficiency (S)
• Cancer, chemotherapy (vincristine) (M)
• Chronic kidney disease (uraemia) (B)
• Connective tissue disease (B)
• CIDP (M)
• Diabetes (B)
• Drugs (isoniazid & phenytoin) (S)
• Endocrine → hypothyroidism (B)
• Folate deficiency (S)
• Granulomatous disease → sarcoidosis (B)
• HSMN (M)
• Infective → Lyme disease, HIV, leprosy (S)

ABCDEFGHI

Question 8

Causes of proximal myopathy

Answer 8

• Rhabdomyolysis
• Autoimmune → polymyalgia rheumatica, SLE, rheumatoid arthritis, vasculitis, inclusion body myositis, sarcoidosis
• Medication → steroids & statins
• Paraneoplastic syndromes
• Congenital → muscular dystrophy & mitochondrial myopathy
• Endocrine → diabetes, hypothyroidism & Addison’s

Question 9

Causes of ptosis

Answer 9

Neurological:
* 3rd nerve palsy
* Horner’s syndrome
* Bell’s palsy

Muscular:
* Myesthenia gravis
* Myotonic dystrophy

Genetic:
* Mitochondrial disease

Question 10

Causes of spastic paraparesis

Answer 10

• Cerebral palsy
• Hereditary spastic paraparesis
• HTLV-1
• Multiple sclerosis
• Trauma
• Anterior horn disease → MND
• Cord compression → tumour, abscess, disc disease, haemorrhage & TB

MATCH

Question 11

Causes of medical 3rd nerve palsy

Answer 11

• Mononeuritis multiplex
• Multiple sclerosis
• Weber’s
• Migraine

Question 12

Causes of facial nerve palsy

Answer 12

• Bells’ palsy
• Ramsey-Hunt
• Space-occupying lesion
• Mononeuritis multiplex

Question 13

Causes of Bulbar palsy

Answer 13

• MND
• Myasthenia gravis
• Myotonic dystrophy
• Medullary stroke

Question 14

Causes of pseudobulbar palsy

Answer 14

• MS
• MND
• High brainstem tumour
• Bilateral internal capsule stroke

Question 15

Causes of surgical 3rd nerve palsy

Answer 15

• Posterior communicating artery aneurysm
• Tumour
• Raised intracranial pressure

Question 16

Causes of mononeuritis multiplex

Answer 16

• Diabetes mellitus
• Vasculitis → particularly polyarteritis nodosa
• Amyloidosis
• Direct tumour involvement → Lymphoma, leukemia
• Connective tissue disease → rheumatoid arthritis, systemic lupus erythematosus
• Paraneoplastic syndromes

Question 17

Causes of Sensory Predominant Upper Motor Neuron Disorder

Answer 17

• SCDC
• MS
• Friedrich’s ataxia

Question 18

Causes of sensorimotor upper motor neuron findings

Answer 18

• Myelopathy
• MS
• SCDC

Question 19

Causes of sensory predominant peripheral neuropathy

Answer 19

• Diabetes
• B1 & B12 deficiency
• Drugs (isoniazid & phenytoin)
• Folate deficiency
• Infective → Lyme disease, HIV, leprosy