Neurology for paces

Question 1

Peripheral neuropathy 2 main findings? Most common DDx

Answer 1

Arflexia
sensory loss

Differential
* Diabetes
* Alcohol
* B12
* CIDP
* paraneoplastic
* Frederick’s ataxia
* charcot marie tooth (pes cavus and wasting)
* Drugs - Cant Veel PAIN
* If acute - consider GBS

Question 2

Parkinsonism key exam fidnings?
DDx?

Answer 2

Bradykinesia
Rigiditt
tremor
Postural instabilitty
[reduced expression, reduced arm swing, asymetry]

• Parkinsons Disease
• Vascular parkisinsons
• Drug induced
• Parkinsons plus - PSP, MSA, CBD
• Lew body dementia
• Wilsons
• If tremor only -> Essential tremor, drug induced, dystonic tremor

Question 3

Spastic paraperisis

Answer 3

Upper motor neurone findings in lower limbs
- Increased tone / clonus
- Weakness
- Waiding gait
- Look at spine

Demyelinating eg MS
Cord comression
Hereditary - spastic paraperesis
Spinal stroke

Question 4

Cerebellar syndrome

DDx

Answer 4

Spinocerebella ataxia (esp brisk reflexes)
Frederick’s
Ataxia telangectasia

Alcohol
Nutritional b1/12
Paraneoplastic
Posterior fossa lesion
MS
Drugs - Phenytoin
Hereditary

Question 4

Hemiplegia DDx

Answer 4

• Vascular - Thrombosis, haemorrhage, embolism
• Tumour / SOL

Question 5

MND differentials

Answer 5

• Cervical cord compression
• Motifocal motor neuropathy with conduction block
• Demyelination
• Kennedy

Question 6

** add in Myotonic
FSCH
Inclusoin bidy myosistis

Answer 6

FS- Weakness in face, shoulders, upper limbs, scapular. winging

Finger flexors and kene exensiors

Question 7

ptosis cause unilateral? bilateral?

Answer 7

Uni
- CN3 palsy (normal / big) , horners (small pupil)
- Look for forhead sparing or not

Bilat
- myaesthenia, myopathy eg myotonic dystrophy