Neurology 2

Question 1

HTN is the most common cause of ICH. What are the two most common areas of the brain affected?

Answer 1

1. Putamen (1/3)

2. Thalamus (10-15%)

Question 2

Internuclear ophthalmoplegia, seen in MS, is caused by a lesion to what part of the Brain?

Answer 2

Medial Longitudinal Fasciculus (MLF) of brain.

Question 3

What is uhthoff’s phenomenon in MS?

Answer 3

Heat sensitivity, where increase in heat causes symptoms to occur or worsen existing symptoms.

Question 4

What are the two most common eye presentation of MS?

Describe them.

Answer 4

1. Optic Neuritis = eye pain with central vision loss (scatoma) and afferent pupillary defect/marcus gunn pupil (paradoxical dilation of affectedly in swing light test when light is moved away from normal eye)
2. Internuclear ophtalmoplegia = ADduction problem of eye ipsilateral to MLF lesion.

Question 5

What is the natural course of most MS patients and what % has this type?

Answer 5

2/3 of MS patients have relapsing and remitting type.

ONLY 20% have primary progressive disease.

Question 6

What is Lhermitte’s sign in MS

Answer 6

Transient sensation of electric shock that runs down spine and extremities, during flexion.

Question 7

Treatment of acute MS flair is?

Answer 7

IV Corticosteroids for 3-7 days.

Question 8

Neurofibromatosis Type 1 diagnosis requires two of what seven criterion?

Answer 8

1. six or more cafe au lait spots (5 mm before puberty, 15 mm after puberty.
2. axillary/inguinal freckling
3. optic glioma
4. neurofibromas
5. first degree relative with NF1
6. lisch nodules (Iris hamartomas)
7. Bony lesions (splenoid dysplasia or long bone thinning)

Question 9

what is the hallmark symptoms of Neurofibromatosis Type 2

Answer 9

1. Bilateral acoustic Schwannomas.

IF unilateral Schwannoma, meets criteria for dx NF 2 if first degree relative with NF2

Question 10

What is Transient Global Amnesia?

Who typically gets this?

Suspected pathophysiology?

What is preserved?

When does it occur and what is the treatment?

Answer 10

Reversible (usually couple hours) and short lived anterograde and retrograde memory loss. Inability to acquire new information or remember events during attack.

Middle aged MEN

Postulated to be due to TIA

Personal identity information is not affected, NO motor symptoms, and no LOC change.

Usually onset during physical exertion, sexual exertion, or extreme temperature exposure.

No treatment required and benign.