Epilepsy
Headache
Neuromuscle
Peds
Imaging
100
7 year old seems to be spacing out a lot. Teacher thinks he has ADHD. Referred to neurology. EEG shows 3 hz spike and wave while he's spacing out. What does he have?
Absence seizures (specifically childhood absence epilepsy)
100
35 yo male with severe right sided headaches lasting about two hours. Says his right eye waters and turns red and his nose gets runny. Worse at night. What headache does he have?
Cluster headaches
100
53 yo female having difficulty keeping eyes open. Also has some double vision and has been having a hard time walking up and down stairs. Symptoms always get worse towards end of day. What do you suspect?
Myasthenia gravis
100
12 month old referred to you for loss of milestones. Seems spastic and twitches a lot. Was healthy first few months of life. Fundoscopic exam shows cherry red spot. No hepatomegaly. What does he have?
Tay-sachs
100
epidural hematoma
200
Name at least two antiseizure medications that are teratogenic
valproic acid, phenobarbital, phenytoin, carbamazepine, topiramate
200
65 year old female with severe right sided headaches that last seconds. They are localized mostly to right cheek. Can be triggered by touch. No other symptoms. What does she have?
Trigeminal neuralgia
200
3 yo male referred to you for developmental delay. Can walk but isn't running. Has a hard time standing up from a seated position. You notice calves seem to be really big. What are you worried about?
Duchenne muscular dystrophy
200
3 yo female has several hypopigmented spots on body and developmental delay. Has a heart murmur. Parents notice that she has started to have right arm jerking episodes. What condition do you suspect?
Tuberous sclerosis
200
Cherry red spot
300
60 yo male has episodes of behavioral arrest, right arm jerking and then whole body shaking. What specific part of his brain is most likely to be abnormal?
Left mesial temporal lobe (including hippocampus)
300
22 yo male has had headaches for about a year. First was intermittent but now occurs daily. Usually 5/10 and holocephalic. Has not changed in character. Doesn't improve despite taking Tylenol and Motrin daily. What are you suspicious of?
Medication overuse headache
300
What is the classic CSF finding seen in Guillian-Barre syndrome?
albuminocytologic dissociation
300
18 month old brought in by parents for a 10 minute episode of generalized shaking. Was out of it for a little bit but now seems back to normal and is playful. Parents say he has an ear infection. What did the patient have?
Simple febrile seizure
300
Neurofibromatosis type 1
400
14 yo female is brought in by parents for a 2 minute episode of generalized shaking after staying up late. On review she says she notices she is very "jerky" in the morning and sometimes looses her grip on objects. What syndrome do you suspect?
Juvenile myoclonic epilepsy
400
Name at least three medications that are commonly used for migraine prophylaxis
verapamil, propranolol, topiramate, cyproheptadine, amitriptyline, valproic acid
400
52 yo male with progressive lower and upper extremity weakness. Some difficulty swallowing. No cognitive changes. Has fasciculations but interestingly also is hyperreflexic. What are you most worried about?
Bonus points if you know treatment
ALS
Riluzole
400
5 yo female with ataxia and recurrent infections. Her eyes look like this. What's the condition?
Ataxia telangiectasia
400
Multiple sclerosis (Dawson fingers)
500
Name at least three antiseizure drugs that are used in treatment of status epilepticus
Lorazepam, midazolam, fosphenytoin, keppra, valproic acid, phenobarbital, pentobarbital, ketamine
500
17 yo female has episodes of right sided weakness that occurs with really severe headaches. Has nausea and photophobia. These episodes last for hours but then resolve completely. Interestingly dad has the same issue. What do you suspect?
Familial hemiplegic migraine
500
20 yo female presents for evaluation of distal extremity numbness/tingling and weakness. Has been present throughout life. Mom has the same issue. You notice her feet look like that
Charcot Marie Tooth (likely type 1)
500
5 yo male with progressive clumsiness. MRI shows a brain mass as well as smaller masses along the spinal cord
Medulloblastoma with drop mets
500
Neurocysticercosis