syndrome-based clinical approach

Question 1

which has more diffuse and which more focal atrophy? UMN or LMN

Answer 1

diffuse: UMN
local: LMN

Question 2

which has more severe atrophy? UMN or LMN?

Answer 2

less severe: UMN

more severe: LMN

Question 3

myopathic causes of atrophy presentation

Answer 3

reflexes decrease later in course

sensation preserved

proximal muscles affected

Question 4

If the diplopia improves by covering either eye, consider…

Answer 4

problem with the extraocular muscles or the cranial nerves innervating them.

Question 5

If the diplopia improves by covering only one eye, consider …

Answer 5

problem with the lens or retina of that eye

Question 6

causes of transient monocular blindness vs transient dimming of both eyes

Answer 6

mono: ischemia of the optic nerve or retina from impaired ipsilateral carotid artery flow

both: presyncope or intermittently increased
intracranial pressure affecting both optic nerves

Question 7

which artery would cause ischemia affecting bilateral

visual (occipital) cortex leading to permanent blindness in both eyes?

Answer 7

vertebrobasilar artery

Question 8

cause of wide based gait

Answer 8

cerebellar ataxia

sensory loss

Question 9

causes of steppage gait

Answer 9

peroneal nerve or L5 root lesion

Question 10

cause of hip waddling gait

Answer 10

myopathy

Question 11

cause of scissors gait

Answer 11

spastic paraparesis

Question 12

post-ictal state

Answer 12

20-30 min

confused, disoriented, agitated, amnesia