Neurology Post

A 68-year-old patient presents with drooping of the right side of the face. He is unable to close his right eye or raise his right eyebrow. On examination, his forehead is also affected. Where is the lesion?

• Left corticospinal tract

• Right facial nerve (peripheral)

• Right motor cortex (central)

• Right trigeminal nerve

A 55-year-old man presents with slurred speech and difficulty swallowing. On exam, he has tongue fasciculations and weakness in all four limbs, but his sensory exam is normal. Which condition is most likely?

• Multiple sclerosis

• Myasthenia gravis

• Amyotrophic lateral sclerosis (ALS)

• Guillain-Barré syndrome

During a neurologic exam, a patient is asked to touch their nose and then touch the examiner’s finger. The movement is slow and uncoordinated, with an intention tremor. This finding suggests dysfunction in:

• The motor cortex

• The cerebellum

• The basal ganglia

• The spinal cord

Which of the following best differentiates between an upper motor neuron (UMN) and a lower motor neuron (LMN) lesion?

• Reflexes: Increased in UMN, decreased in LMN

• Muscle tone: Decreased in UMN, increased in LMN

• Atrophy: Common in UMN, absent in LMN

• Fasciculations: Present in UMN, absent in LMN

A 73-year-old man has difficulty walking. His gait is wide-based and unsteady, and he has difficulty stopping quickly. Romberg’s test is negative. Where is the most likely site of the lesion?

• Vestibular system

• Dorsal columns of the spinal cord

• Cerebellum

• Basal ganglia