Test Your Neurology Knowledge Quiz

Which of the following are clinical signs of an upper motor neurone problem?

A 32 year old gentleman is brought into A&E by ambulance following a car accident. He has multiple injuries, and is unresponsive. After his airway, breathing and circulation are assessed and stabilised, the doctor goes to assess his level of consciousness using the Glasgow Coma Scale (GCS). He does not open his eyes at any stage, but tries to withdraw his arm and groans in response to painful stimuli. What is his GCS?

A 27 year old woman presents to her GP with a history of severe headache. She reports that these headaches have occurred 4 times in the last 3 months and have been predominantly left -sided and associated with visual disturbance and vomiting. They last several hours at a time and are so severe she has been unable to go to work. She reports that she is able to predict when she will get one of these headaches as the day before she is off her food, nauseated and the visual disturbances, which are flashing lights across her field of vision, begin. What is the likely diagnosis?

A 68 year old woman presents with double vision. On examination she has a ptosis of her left eye and when her eyelid is raised the eye is pointing inferiorly and laterally. On assessing her eye movements, these were normal in the right eye, but her left eye was unable to look right or upwards. Her left pupil was dilated. What is the likely diagnosis?

Which of the following are risk factors for stroke?

A 44 year old gentleman presents to A&E with a severe headache. He said it came on quickly, within 30 seconds, and is at the back of his head. He reports feeling nauseated and 'unsteady'. On examination he has mild neck stiffness, nystagmus on left and right gaze and is walking with a very unsteady, broad-based gate, wobbling from side-to-side. What is the likely diagnosis?

A 13 year old boy presents with facial weakness. On examination he has paralysis of his facial muscles on the left hand side, including the left side of his forehead. He has a mild ptosis of his left eye. What is the likely diagnosis?