Neuro Clinical Cases

Bitemporal hemianopsia

tumor of adenohypophysis/ optic chiasm affected

- can wrinkle forehead but left side of moth drooped

- collapsed on the street

- epicritic sensation lost

- protopathic sensation lost

- UMN syndrome

lesion to right genu and posterior limb of internal capsule

-alcoholic

- ataxic broad base gate

- cnat perform heel to shin or finer to nose test

degeneration of vermis

- horners

- ataxia

- spinothalamic that affects the left side of the body

-tendency to fall to the right

-horseness + difficulty swallowing

lateral medullary syndrome (PICA/wallenbergs syndrome) on the right side

- left side paralysis

- blind left eye

- left homonymous hemianopsia

lesion to right cerebellar peduncle and optic tract

persistent erection

constricted pupils

decreased resp. rate

tumor in anterior 3rd ventricle that affects the anterior hypothalamus

flinging of right upper limb

hemiballism damage to the subthalamic nucleus

pigmentation of corneal scleral junction

trembling of arms and legs

wilsons disease bilateral lesion to globus pallidus and putamen

trembling hands + stiffness

"pill rolling tremor"

masked expression

parkinsons bilateral lesion to substantia nigra

depression

unsteady balance

facial grimacing

hypotonia

huntingtons bilateral lesion to caudate and putamen

athlete with leg weakness that progessess to an inablility to walk

meningioma of falx cerebri in the medial longitudinal fissure that affects the motor cortex

blurred vision

rt visual field deficits

respiratory issues

difficulty following eye movements when following objects across the left visual field

lesion to occipital cortex that affects broadman areas 17 (visual) and 18 & 19 (optokinetics)

cant smell

urinated on the floor

tumor of anterior cranial fossa frontal lope and olfactory bulbs and tracts

smelled something burning

hallucinations

saw "trains"

left upper quandrantanopsia (meyers loop affected)

hallucinations

temporal lobe tumor

hard time hearing

couldn't understand what she said

inserted words and phrases into speech

auditory/wernicks apahsia lesion to broadmans area 22

couldn’t pass pencil test/difficulty with writing

cant read

lesion of inferior parietal lobule in the left cerebral cortex (gertsmann syndrome)

leaves shoe and sock on left side when gts

odd behavior

cant draw properly

lesion of inferior parietal lobule in the right cerebral cortex

pain in back and Rt leg

decreased muscle tone & hypotonia in right leg

lesion to left anterior horn in lumbosacral enlargement

hypertonicity of right limbs

dysarthria

dorsal column medial meniscus affected

deviation of tongue to the left

middle medullary syndrome on the left side

UMN syndrome, left lower limbs affected

dorsal column medial meniscus affected

spinothalamic affected on right side

brown sequard on the left side

unsteady walking and trunkal ataxia

tumor in 4th ventricle that affects the vermal area and pontomedullary vestibular area

double vision

left side of face drooped

loss of pain and temp on right side of face

loss of epicritic sensation on right upper and lower limbs

left dorsomedial pons lesion that affects facial and abducens and medial leminiscus

hypotonia of lower limbs

bilateral los of 2pt discrimination, vibration sense, etc

urine retention

tabes dorsalis

hard time working: double vision and left arm shaking

ptosis

external strabismus of right eye

anesthesia of left body

dilated right pupil

left upper limb intention tremor

right benedikts syndrome

broad base gait

difficulty chewing

weakness of mastication muscles on left side

left corner of mouth drooping

cant close left eye

tumor of left vestibulo-cochlear nerve in cerebellopontine angle that affects the trigeminal and facial nerve

lower limb paralysis

decreased size of upper limb muscles

deep tendon decreased in upper limbs and increased in lower limbs

ALS

loss of pain and temp in right hand

no pin prick response

weakness of both upper limbs

syringomyelia

internal strabismus of right eye

paralysis of left limbs

cant close right eye

sounds are louder in the right ear

millard gubler syndrome

mitosis, pitosis, etc

paralysis of right side

spinothalamic affects left side of body at C7

infarct on right side of spinal segmant C7 lesion to anterior spinal cord and lateral horn

cant adduct either eye

abducting in tact

horizontal nystagmus in abducting eye

could adduct during convergence

bilateral MLF lesion anterior internuclear opthalmoplegia

ataxic broad base gait

weak lower limbs/hypotonic

decreased deep tendon reflex

lesion to bilateral dorsal column and lateral corticospinal tract in the spinal cord

external strabismus of right eye

dilated right pupil

UMN syndrome

left deviation of tongue

right webers syndrome superior alternating hemiplagia

first visit:

loss of sensations below mid thoracic region + muscle paralysis

urine retention

second visit:

return of pressure, touch, position sense

bladder/bowel incontinence

lesion to entire spinal cord except left fasciculus cuneatus

lateral deviation of left jaw

paralysis of left upper and lower limbs

cant bite down on left side

trigeminal alternating hemiplagia lesion to left caudal pons that extends all the way to the side

internal strabismus of left eye

paralysis of right upper and lower limbs

lesion to caudal pons that affects the abducens and corticospinal tract