Neuro Diagnostic Clues

Front 1

Onset of Seizure, Migraine, Vascular lesion

Back 1

RAPID, LOCALIZED

Front 2

Onset of Transient Ischemic Attack

Back 2

GRADUAL AND LESS LOCALIZED

Front 3

Onset of Ischemia

Back 3

STUTTERING ONSET

Front 4

Onset of Toxic, Metabolic, Infectious, Inflammatory

Back 4

GRADUAL OVER HOURS

Front 5

Onset of Multiple Sclerosis

Back 5

RELAPSING, DIFFERENT LEVELS

Front 6

Onset of Neurodegenerative, Neoplasm, Chronic Inflammation

Back 6

SLOW PROGRESSION

Front 7

Site of Cranial nerve lesion; crossed weakness

Back 7

BRAIN STEM

Front 8

Site of “Long Tract” disorders of motor, sensory, visual, or cerebellar pathways

Back 8

White matter - Cerebrum

Front 9

Site of Cognitive impairment; movement disorder; seizure

Back 9

Gray matter [neuronal]- Cerebrum

Front 10

Site of Mixed upper and lower motor neuron changes; weakness sparing head

Back 10

SPINAL CORD

Front 11

Site of Metabolic; degenerative

Back 11

PROGRESSIVE, SYMMETRIC, NOT CIRCUMSCRIBED

Front 12

Tear of a superior cerebral vein as it enters the Saggital Sinus

Back 12

Subdural Hematoma

Front 13

Severe headache followed by drowsiness, confusion, contralateral weakness, positive Babinski reflex

Back 13

Subdural Hematoma

Front 14

Tear of Middle Meningeal Artery [usual]

Back 14

Epidural Hemorrhage

Front 15

Rapid onset; drowsiness, confusion; symptoms depend upon site of pressure

Back 15

Epidural Hemorrhage

Front 16

Bleeding is localized and spreads along ____ pathways

Back 16

white matter

Front 17

____ is a significant factor for large artery thrombotic stroke

Back 17

Carotid stenosis

Front 18

Small vessel disease refers specifically to ___

Back 18

penetrating arteries

Front 19

Small vessel disease can cause what type of infarcts?

Back 19

small deep [lacunar] infarcts

Front 20

Embolic fragments originate in the ____. Defects are of sudden onset, may resolve.

Back 20

heart or aorta

Front 21

Systemic hypoperfusion may lead to ___.

Back 21

ischemia.

Front 22

Those of sub-Saharan origin, Asians, and women have a lower incidence of occlusive disease of the___ and ___ than do men of European origin

Back 22

extracranial carotid and vertebral arteries

Front 23

____ hemorrhage is more common among those of sub-Saharan origin or Asian origin.

Back 23

Hypertensive intracerebral

Front 24

___ is typically a feature of hemorrhagic strokes

Back 24

Headache

Front 25

___ is common in patients with intracerebral hemorrhage, subarachnoid hemorrhage, and vertebrobasilar artery ischemia

Back 25

Vomiting

Front 26

Reduced alertness favors ___

Back 26

hemorrhage

Front 27

Accompanying neurologic signs favor ___ hemorrhage

Back 27

intracerebral

Front 28

Loss of consciousness, ___ artery ischemia.

Back 28

vertebrobasilar

Front 29

Multifocal headaches and headaches described as sharp and stabbing have a ___ cause

Back 29

benign

Front 30

____ headache is unilateral, pounding

Back 30

Temporal arteritis

Front 31

___ lesions present with occipito- nuchal headaches

Back 31

Posterior fossa

Front 32

___ lesions present with fronto- temporal headaches. Prostrating. Invariably unilateral.

Back 32

Supratentorial

Front 33

___ headache is of sudden onset [“thunderclap”].

Back 33

Aneurysm

Front 34

___ irritation presents with nuchal rigidity

Back 34

Meningeal

Front 35

___ may present with severe eye pain. The pupil may be dilated. The eye is red

Back 35

Glaucoma

Front 36

___ have slow buildup and last for hours. Can wake patient, visual disturbances, Light and sound intolerance. Nausea and vomiting, rapid pulse and sweating

Back 36

Migraines

Front 37

___ pain is most common pattern in migraine

Back 37

Hemicranial

Front 38

What the sensory system input from meningeal vessels can initiate migraines?

Back 38

trigemino-vascular

Front 39

A ___ headache has sudden onset, peaks in 3-5 minutes, and rapidly dissipates. Occur in cycles.

Back 39

cluster

Front 40

Episodic, daily headache for at least 3 weeks. May have several daily. Cycle terminates spontaneously. Cycle can recur years later.

Back 40

CLUSTER HEADACHE

Front 41

Unilateral periorbital pain with an ipsilateral red, watery eye. Nasal discharge and nasal congestion may be present. [Possibly ipsilateral Horner’s syndrome].

Back 41

CLUSTER HEADACHE

Front 42

Very brief, sharp, severe pains located in the scalp outside of the trigeminal distribution are named by their defining characteristic as "___."

Back 42

ice pick pains

Front 43

FEATURES OF DELERIUM: Infectious meningitis, anticholinergic intoxication, withdrawal from ethanol or sedative drugs, sepsis

Back 43

Fever

Front 44

FEATURES OF DELERIUM: Intoxication with ethanol or sedative drugs, hepatic encephalopathy, hypoglycemia, hypothyroidism, sepsis

Back 44

Hypothermia

Front 45

FEATURES OF DELERIUM: Anticholinergic intoxication, withdrawal from ethanol or sedative drugs, hypertensive encephalopathy, subarachnoid hemorrhage, sympathomimetic intoxication

Back 45

Hypertension

Front 46

FEATURES OF DELERIUM: Anticholinergic intoxication, withdrawal from ethanol or sedative drugs, thyrotoxicosis, sepsis

Back 46

Tachycardia

Front 47

FEATURES OF DELERIUM: Hypothyroidism

Back 47

Bradycardia

Front 48

FEATURES OF DELERIUM: Hepatic encephalopathy, hyperglycemia, sepsis

Back 48

Hyperventilation

Front 49

FEATURES OF DELERIUM: Meningitis, subarachnoid hemorrhage

Back 49

Meningismus

Front 50

FEATURES OF DELERIUM: Meningococcal meningitis

Back 50

  Skin rash

Front 51

FEATURES OF DELERIUM: Hypocalcemia

Back 51

Tetany

Front 52

FEATURES OF DELERIUM: Hypertensive encephalopathy, intracranial mass

Back 52

Papilledema

Front 53

FEATURES OF DELERIUM: Head trauma, anticholinergic intoxication, withdrawal from ethanol or sedative drugs, sympathomimetic intoxication

Back 53

Dilated pupils

Front 54

FEATURES OF DELERIUM: Opioid intoxication

Back 54

Constricted pupils

Front 55

FEATURES OF DELERIUM: Intoxication with ethanol, sedative drugs, or phencyclidine, vertebrobasilar ischemia, Wernicke encephalopathy

Back 55

Nystagmus/ophthalmoplegia

Front 56

FEATURES OF DELERIUM: Withdrawal from ethanol or sedative drugs, sympathomimetic intoxication, thyrotoxicosis

Back 56

Tremor

Front 57

FEATURES OF DELERIUM: Metabolic encephalopathy

Back 57

Asterixis

Front 58

FEATURES OF DELERIUM: Cerebral infarction, head trauma, hyperglycemia, hypoglycemia

Back 58

Hemiparesis

Front 59

FEATURES OF DELERIUM: Withdrawal from ethanol or sedative drugs, head trauma, hyperglycemia, hypoglycemia

Back 59

Seizures

Front 60

FEATURES OF DELERIUM: Intoxication with ethanol or sedative drugs, Wernicke encephalopathy

Back 60

Ataxia

Front 61

Which drug of abuse presents with pinpoint pupils and depressed reflexes?

Back 61

Opiates

Front 62

Drug of Abuse? Hypokinesia, Euphoria, somnolence

Back 62

Opiates

Front 63

Drug of Abuse? Tremor, Euphoria, hallucinations, panic

Back 63

LSD

Front 64

Which Dementia?  Unprotected sexual intercourse, intravenous drug abuse, hemophilia, or blood transfusions

Back 64

HIV-associated dementia

Front 65

FEATURES OF DEMENTIA: Hypothermia and Hypotension

Back 65

Hypothyroidism

Front 66

FEATURES OF DEMENTIA: Hypertension

Back 66

Vascular dementia

Front 67

FEATURES OF DEMENTIA: Chronic meningitis

Back 67

Meningismus

Front 68

FEATURES OF DEMENTIA: Acquired hepatocerebral degeneration

Back 68

Jaundice, Asterixis

Front 69

FEATURES OF DEMENTIA: Brain tumor, chronic subdural hematoma

Back 69

Papilledema

Front 70

FEATURES OF DEMENTIA: Neurosyphilis

Back 70

Argyll Robertson pupils

Front 71

FEATURES OF DEMENTIA: Progressive supranuclear palsy

Back 71

Ophthalmoplegia

Front 72

FEATURES OF DEMENTIA: Vascular dementia, progressive supranuclear palsy

Back 72

Pseudobulbar palsy

Front 73

FEATURES OF DEMENTIA: Dementia with Lewy bodies, corticobasal ganglionic degeneration, acquired hepatocerebral degeneration, Wilson disease, HIV-associated dementia

Back 73

Tremor

Front 74

FEATURES OF DEMENTIA: Creutzfeldt-Jakob disease, HIV-associated dementia

Back 74

Myoclonus

Front 75

FEATURES OF DEMENTIA: Dementia with Lewy bodies, corticobasal ganglionic degeneration, acquired hepatocerebral degeneration, Creutzfeldt-Jakob disease, progressive supranuclear palsy, Wilson disease

Back 75

Rigidity

Front 76

FEATURES OF DEMENTIA: Huntington disease, Wilson disease

Back 76

Chorea

Front 77

FEATURES OF DEMENTIA: Normal pressure hydrocephalus

Back 77

Gait apraxia

Front 78

FEATURES OF DEMENTIA: Neurosyphilis, vitamin B12 deficiency, HIV-associated dementia

Back 78

Polyneuropathy with hyporeflexia

Front 79

DEMENTIA OR DEPRESSION? Indifferent to memory impairment. Semantic paraphasia.

Back 79

DEMENTIA

Front 80

DEMENTIA OR DEPRESSION? Cognitive deficit

Back 80

DEMENTIA

Front 81

DEMENTIA OR DEPRESSION? Signs of depression secondary

Back 81

DEMENTIA

Front 82

DEMENTIA OR DEPRESSION? Rarely past history of depression

Back 82

DEMENTIA

Front 83

DEMENTIA OR DEPRESSION? Can describe memory impairment precisely and in detail

Back 83

DEPRESSION

Front 84

DEMENTIA OR DEPRESSION? No or minimal cognitive deficit

Back 84

DEPRESSION

Front 85

DEMENTIA OR DEPRESSION? Brooding, anxiety, sleep disturbance, loss of appetite, self doubt at presentation

Back 85

DEPRESSION

Front 86

DEMENTIA OR DEPRESSION? Usually past history of depression

Back 86

DEPRESSION

Front 87

SYNCOPE OR SEIZURE? Incontinence or even some automatisms (lip smacking)

Back 87

DO NOT distinguish syncope from seizure.

Front 88

SYNCOPE OR SEIZURE? aura associated with its onset. Sweating, nausea, pallor are not described. Following the seizure the patient may have myalgias. Mental confusion may persist for minutes.

Back 88

SEIZURE

Front 89

SYNCOPE OR SEIZURE? no aura. Sweating, nausea, pallor are generally described. Following the episode, mental confusion may last for seconds. Myalgias are uncommon

Back 89

Syncope

Front 90

SYNCOPE OR SEIZURE? occurs generally in the daytime. It does not awaken from sleep

Back 90

Syncope

Front 91

SYNCOPE OR SEIZURE? may occur at any time and may awaken from sleep

Back 91

Seizures

Front 92

SYNCOPE OR SEIZURE? episodes are brief [seconds]

Back 92

Syncopal

Front 93

SYNCOPE OR SEIZURE? last minutes

Back 93

seizures

Front 94

Usual causes of syncope are ___

Back 94

neurocardiogenic [20%]

Front 95

two concurrent events of Seizures

Back 95

High frequency bursts of action potentials, followed by a hyperpolarizing after-potential mediated by GABA receptors or Potassium ion channels depending upon cell type

Front 96

Repetitive discharges lead to an increase in extracellular Potassium ion , which blunts hyper-polarization and depolarizes neighboring neurons.

Back 96

Hypersynchronization

Front 97

Site of Seizure: Abrupt onset. May occur several times daily. Adversive head movements or complex movements. Mood change. Autonomic dysfunction. Speech arrest. Limited post-ictal confusion.

Back 97

Frontal lobe

Front 98

Site of Seizure: Nausea, heat sensation. Visual or auditory hallucinations. Compulsive thoughts; déjà vu; automatisms. Dyspnea, palpitations, urinary urgency. Post-ictal confusion.

Back 98

Temporal lobe

Front 99

Site of Seizure: Sensory and major motor [Jacksonian] seizures. Post-ictal confusion.

Back 99

Parietal lobe

Front 100

Site of Seizure: Unformed visual hallucinations.

Back 100

Occipital lobe

Front 101

Which PARTIAL SEIZURES? No loss of consciousness; seizures involve only sensory or motor systems

Back 101

Simple

Front 102

Which PARTIAL SEIZURES? Impaired consciousness; onset localized, but spreads; involves limbic system; usually involves temporal lobe; may involve automatisms

Back 102

Complex

Front 103

Which GENERALIZED SEIZURES? Loss of consciousness; associated with generalized tonic muscle contractions [flexion: arms; extension: legs] followed by rhythmic contractions of limbs. Post-ictal phase can involve altered consciousness. 10-12Hz spikes on EEG .

Back 103

Tonic-clonic [Grand mal]

Front 104

Which GENERALIZED SEIZURES? Loss of consciousness; rigid, violent muscle contractions; limbs fixed in abnormal positions

Back 104

Tonic

Front 105

Which GENERALIZED SEIZURES? Loss of consciousness; rhythmic muscle jerks; involves all parts of the body

Back 105

Clonic

Front 106

Which GENERALIZED SEIZURES? Brief loss of consciousness; may be frequent . 3Hz bilateral discharges on EEG.

Back 106

Absence [Petit mal]

Front 107

Which GENERALIZED SEIZURES? Sudden loss of muscle tone [fall]

Back 107

Atonic

Front 108

Age group of seizure? ischemia, hypoxia, trauma, metabolic [glucose, Calcium, Magnesium, pyridoxine],developmental, genetic

Back 108

Neonates

Front 109

Age group of Seizure? infection, trauma, genetic

Back 109

Infants [1 month – 12 years of age]

Front 110

Age group of seizure? trauma, infection, genetic, tumor, drugs

Back 110

Adolescents [12-18 years of age]

Front 111

Age group of seizure? trauma, alcohol or drugs, tumor

Back 111

Young Adults [18 – 35 years of age]

Front 112

Age group of seizure? CVA, tumor, alcohol or drugs, metabolic, degenerative

Back 112

Adults [over 35 years of age]

Front 113

A first seizure in someone older than 40 should raise the possibility of ___

Back 113

bacterial endocarditis

Front 114

Loss of muscle tone triggered by emotional stimuli. May occur with narcolepsy.

Back 114

Catalepsy

Front 115

Disequilibrium suggests a ____

Back 115

central process

Front 116

Vertigo as a ___ is associated with short course, precipitating factor, autonomic symptoms. Facial sensory changes and tinnitus may be described. Nystagmus is always present; unidirectional, never vertical

Back 116

peripheral process

Front 117

Vertigo as a ___ process may have no obvious precipitating factor. Autonomic symptoms are not prominent. Ataxia, sensory and motor symptoms. Nystagmus may be absent; if present, is uni- or bidirectional or may be may be vertical

Back 117

central

Front 118

In ATAXIA, Cerebellar lesions are ___

Back 118

ipsilateral

Front 119

Unable to stand with feet together. Lurch. May see to and fro movement of trunk. “Drunken” gait. This is a lesion of the___

Back 119

anterior lobe of Cerebellum

Front 120

Lesions of the vermis involve ___

Back 120

gait disturbance alone

Front 121

___ lesions are associated with limb ataxia and nystagmus. The shoulder is lower on the affected side. The patient falls to the side of the lesion

Back 121

Cerebellar hemispheric

Front 122

Lesions of the ___ are associated with truncal ataxia. There is no motor incoordination but the inability to stand upright without support

Back 122

4th Ventricle

Front 123

Upper motor neuron disease. Spastic: affected arm flexed and affected leg extended; difficulty in flexing hip and knee as well as dorsiflexing ankle; paretic leg swings out.

Back 123

Hemiparetic

Front 124

Thoracic level lesion. Spastic: slow, stiff movements; hips adducted, legs extended. May cross one leg over the other when walking [“scissor” gait].

Back 124

Paraperetic

Front 125

Substantia nigra lesion. Difficulty initiating movement. General flexion of body. Rigid, with tremor. Short intitiating steps [“shuffle”] with rapid movement at end of sequence [“fenestration”]. May see retropulsive steps if mild force exerted on patient

Back 125

Parkinsonian

Front 126

Sway with eyes closed. Wide based stance. Slap ground with feet [“tabetic”gait].

Back 126

Proprioceptive difficulty

Front 127

Incoordination of voluntary movements is associated with lesions of the ___ of the cerebellum

Back 127

dentate nucleus

Front 128

___ tremor is discrete, asymptomatic. May occur when holding heavy object [isometric]. May be exaggerated with stress

Back 128

Physiologic

Front 129

___ tremor is familial. 60% autosomal dominant. Involves hands, head, voice, trunk [in decreasing frequency]. May be postural. Improved by alcohol

Back 129

Essential

Front 130

__ tremor reflects cerebellar dysfunction. Postural tremor and head/neck tremor may be seen when patient standing.

Back 130

Intention

Front 131

___ tremor seen in nigrostriatal or cerebello-spinothalamic tract lesions [e.g., Parkinson’s]. Usually proximal

Back 131

Resting

Front 132

___ tremor may be proximal or distal.

Back 132

Neuropathic

Front 133

Loss of tonic vestibular discharge on side leads to___.

Back 133

imbalance [nystagmus and vertigo]

Front 134

Peripheral lesions [nerve or receptor destruction] result in ___. Fast component beats away from diseased ear.

Back 134

no brainstem input

Front 135

Central lesions produce ___ nystagmus.

Back 135

vertical

Front 136

which CENTRAL LESIONS? Tendency to fall to ipsilateral side. Diminished caloric sensation on inpsilateral side. Nystagmus to ipsilateral side

Back 136

Horizontal plane

Front 137

which CENTRAL LESIONS? Tendency to fall forward/ backward. Elevator sensation. Nystagmus is vertical

Back 137

Saggital plane

Front 138

which CENTRAL LESIONS? Tendency to fall sideways [latero-pulsion]. Nystagmus is vertical and to side of lesion.

Back 138

Frontal plane

Front 139

___ is associated with bilateral dorsal midbrain lesion. Vertical up and downbeat nystgmaus is present in brain stem lesion.

Back 139

Retraction nystagmus

Front 140

__ aphasia: “Uh..well..umm..like”

Back 140

Global

Front 141

___ aphasia: “1..2..days..bed”

Back 141

Expressive

Front 142

___ aphasia [phonemic paraphrasia]: “When whence beside bespoke”

Back 142

Receptive

Front 143

___ aphasia: “Started..well..started”

Back 143

Conductive

Front 144

___ lesions associated with slurred speech, dyspnea, hoarseness, or whispering. May “speak through nose”.

Back 144

Peripheral

Front 145

___ lesions associated with clipped, scanning speech.

Back 145

Cerebellar

Front 146

___lesions associated with monotonous, soft, slurred speech. May see explosive, loud, uncoordinated, clipped speech, however

Back 146

Basal ganglia

Front 147

Slurred, effortful, slow speech is seen with ___ disturbances

Back 147

metabolic

Front 148

Monotonous, slow, hoarse, pressured speech is seen with ___ lesions. Deep, variable pitch.

Back 148

white matter

Front 149

In the brain stem, ___ signs are contralateral to the lesion. ___ signs are ipsilateral to the lesion.

Back 149

long tract, Cranial nerve

Front 150

At spinal cord level, loss of pain and temperature is on side ___ of lesion. Long tract signs are not all on one side

Back 150

opposite

Front 151

Central monoparesis is distinguished from a peripheral paresis in that contraction of___ muscles is not impaired. For example, the hand may drop but grasp is unimpaired in a central lesion.

Back 151

antagonist

Front 152

In posture, Lesion of the ___ leads to contra-lateral hemiparesis.

Back 152

internal capsule

Front 153

In posture, Lesion of the ___ leads to ipsilateral cranial nerve injury and contra-lateral hemiparesis.

Back 153

brainstem

Front 154

___ occurs at the level of decussation in the pyramids. For example, paresis in the right arm with paresis in the left leg.

Back 154

Crossed paresis

Front 155

In posture, ___ paraparesis occurs because of a lesion in the central spinal cord

Back 155

Spastic

Front 156

___ posture is characterized by limb extension.

Back 156

Decerebrate

Front 157

___ posture is characterized by flexion of the upper limbs with extension of the lower limbs

Back 157

Decorticate

Front 158

An expanding supratentorial mass lesion may cause brain tissue to be displaced into an adjacent intracranial compartment, resulting in 1-4

Back 158

[1] cingulate herniation under the falx, [2] downward transtentorial [central] herniation, [3] uncal herniation over the edge of the tentorium, or [4] cerebellar tonsillar herniation into the foramen magnum.

Front 159

___ sign: ectopic impulse generation with cervical flexion [demyelination of cervical cord]

Back 159

L’Hermitte

Front 160

Symptoms worsen with heat or exercise ___

Back 160

[conduction block in demyelinated nerve]

Front 161

Recurrent dysphagia or dysarthria with exercise or fatigue ___

Back 161

[Myasthenia Gravis]

Front 162

Slowly advancing visual defects with luminous edges ___

Back 162

[Migraine]

Front 163

Constant pain in the ear without evidence of middle ear disease suggests ___.

Back 163

cancer of the pharynx

Front 164

Age of DEVELOPMENTAL MILESTONES? Rooting reflex, Orients to voice

Back 164

0-3 months

Front 165

Age of DEVELOPMENTAL MILESTONES? Moro reflex lost; holds head up, Social smile

Back 165

3 months

Front 166

Age of DEVELOPMENTAL MILESTONES? Rolls front to back; sits propped up, Recognizes people

Back 166

4-5 months

Front 167

Age of DEVELOPMENTAL MILESTONES? Sits alone; crawls, Anxious with strangers

Back 167

7-9 months

Front 168

Age of DEVELOPMENTAL MILESTONES? Upgoing Babinski disappears

Back 168

12-14 months

Front 169

Age of DEVELOPMENTAL MILESTONES? Walks; speaks few words, Separation anxiety

Back 169

15 months

Front 170

Age of DEVELOPMENTAL MILESTONES? Climbs stairs; stacks 3 blocks

Back 170

12-24 months

Front 171

Age of DEVELOPMENTAL MILESTONES? Rapprochment; parallel play; gender identity

Back 171

24-48 months

Front 172

Age of DEVELOPMENTAL MILESTONES? Stacks 9 blocks, Toilet training

Back 172

30-36 months

Front 173

Age of DEVELOPMENTAL MILESTONES? Rides tricycle; copies line and circle, Rides tricycle; copies line and circle

Back 173

3 years

Front 174

Age of DEVELOPMENTAL MILESTONES? Draw stick figure; copy a cross; hop on one foot, Cooperative play; grooms self

Back 174

4 years

Front 175

Age of DEVELOPMENTAL MILESTONES? Copy triangle, Reads; understands concept of death;

Back 175

6 years

Front 176

Age of DEVELOPMENTAL MILESTONES? Rides bicycle, Same sex identification; conscience develops

Back 176

6-11 years

Front 177

Age of DEVELOPMENTAL MILESTONES? Abstract reasoning; forms personality

Back 177

11 years [girls]; 13 years [boys]

Front 178

Facial asymmetry [show teeth or smile]
Arm drift [patient closes eyes and extends both arms straight out for 10 seconds with the palms up; one arm drifts down]
Weak grip [unilateral] or alteration in speech

Back 178

diagnostic of an acute stroke for >45y/o healthy

Front 179

Drug of Abuse?
Chorea, tremor, dystonia, myoclonus
Anxiety, agitation, hypervigliance.

Back 179

Cocaine

Front 180

Drug of Abuse?
Chorea, tremor, muscle spasms
Euphoria or dysphoria, hyperactivity, hypervigilance, hallucinations

Back 180

Amphetamines

Front 181

Drug of Abuse?
Tremor, rigidity
Anxiety, hyperactivity, psychosis

Back 181

MDMA

Front 182

Drug of Abuse?
Ataxia, tremor, increased muscle tone
Euphoria or dysphoria, psychosis, aggression

Back 182

PCP

Front 183

TIA [basilar artery] With dizziness, diplopia, ataxia, or paresthesia
TIA [anterior cerebral artery]
Posterior fossa tumor. Follows flexion of neck.
Colloid cyst of 3rd ventricle. Position dependent headache

Back 183

Drop attack

Front 184

site of DYSEQUILIBRIUM? Nystagmus, head and trunk titubation, gait ataxia
Tumor, multiple sclerosis

Back 184

Midline

Front 185

Site of DYSEQUILIBRIUM?
Gait ataxia
Wernicke encephalopathy, alcoholic cerebellar degeneration, tumor, multiple sclerosis

Back 185

Superior vermis

Front 186

Site of DYSEQUILIBRIUM?
Nystagmus, ipsilateral gaze paresis, dysarthria [especially left hemisphere lesion], ipsilateral hypotonia, ipsilateral limb ataxia, gait ataxia, falling to side of lesion
Infarction, hemorrhage, tumor, multiple sclerosis

Back 186

Cerebellar hemisphere

Front 187

Site of DYSEQUILIBRIUM?
Nystagmus, bilateral gaze paresis, dysarthria, bilateral hypotonia, bilateral limb ataxia, gait ataxia
Drug intoxications, hypothyroidism, hereditary cerebellar degeneration, paraneoplastic cerebellar degeneration, Wilson disease, infectious and parainfectious encephalomyelitis, Creutzfeldt-Jakob disease, multiple sclerosis

Back 187

Pancerebellar

Front 188

Babinski positive
Spasticity
With time, hyperactive reflexes, leading to clonus
Absent cremaster, abdominal reflexes

Back 188

UPPER MOTOR NEURONS problem

Front 189

Flaccidity
Absent reflexes, muscle atrophy
Fasciculations and fibrillation

Back 189

LOWER MOTOR NEURONS problem