USMLE Forum Archives - USMLE Step 2 CK - Neuro 2
Neuro 2
Brainlab - 12-13-06 11:47
A 19-year-old college varsity swimmer and diver develops a headache, dizziness, left-sided arm clumsiness and leg weakness. He also develops loss of pain and temperature sensation in the left facial region and right body areas after a practice session. He denies prior illness or use of medications. There is no family history of any diseases. Which of the following is the most likely diagnosis?
A. Astrocytoma
B. Benign positional vertigo (BPV)
C. Labyrinthitis
D. Multiple sclerosis
E. Vertebral artery dissection
Brainlab - 12-13-06 11:47
A 19-year-old college varsity swimmer and diver develops a headache, dizziness, left-sided arm clumsiness and leg weakness. He also develops loss of pain and temperature sensation in the left facial region and right body areas after a practice session. He denies prior illness or use of medications. There is no family history of any diseases. Which of the following is the most likely diagnosis?
A. Astrocytoma
B. Benign positional vertigo (BPV)
C. Labyrinthitis
D. Multiple sclerosis
E. Vertebral artery dissection
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#1
Re: Neuro 2
Brainlab - 12-16-06 17:20 The correct answer is E. This patient has findings consistent with a lateral medullary syndrome. Given that this patient has subjected himself to strenuous exercise the most likely explanation is a vertebral artery dissection.
An astrocytoma may cause dizziness and unsteadiness along with a headache. Onset is insidious with progressive symptoms (choice A).
Benign positional vertigo (choice B) causes sudden episodes of dizziness, typically with position change, and with no associated neurologic symptoms other than nystagmus.
Labyrinthitis (choice C) causes severe vertigo. Patients find it difficult to move, preferring to remain still.
Multiple sclerosis (choice D) can cause dizziness and clumsiness, but the sudden onset and constellation of findings makes this diagnosis unlikely.
#3
Re: Neuro 2 babbu5508 - 07-06-10 22:45 lateral medullary syndrome is characterized by sensory deficits affecting the trunk and extremities on the opposite side of the infarction and sensory deficits affecting the face and cranial nerves on the same side with the infarct
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