36 Bilateral spastic paralysis (spastic paraplegia) Instruction Carry out a neurological examination of this patient’s lower limbs. Salient features History • Ask about onset, duration and course of symptoms •…
85 Bulbar palsy Instruction Examine this patient’s cranial nerves. Ask the patient a few questions. Test this patient’s speech. Salient features History • Ask the patient about nasal regurgitation, dysphagia…
84 Pseudobulbar palsy Instruction Examine this patient’s cranial nerves. Salient features History • Ask the patient whether there is difficulty in swallowing or nasal regurgitation • Any changes in speech…
80 Orofacial dyskinesia Instruction Look at this patient. Salient features History • Ask the patient about removal of teeth and how long the patient has been edentulous • History of…
79 Hemiballismus Instruction Look at this patient. Salient features History • Sudden onset • Cardiovascular disease for source of emboli: atrial fibrillation, valvular heart disease or severe left ventricular dysfunction….
21 Ventricular septal defect Instruction Listen to this patient’s heart. Salient features History • Small defects are usually asymptomatic • Large defects with shunts: repeated respiratory tract infections, debilitating dyspnoea…
67 Thomsen’s disease (myotonia congenita) Instruction Look at this patient. Salient features History • Ask the patient whether or not there is any seasonal variation in symptoms: myotonia is worse…
58 Proximal myopathy Instruction Perform a neurological examination of this patient’s arms or legs. Salient features History • Weakness of proximal muscles • Patient has difficulty in standing from the…
52 Sixth cranial nerve palsy Instruction Examine this patient’s eyes. Salient features History • Diplopia in all directions of gaze except away from the affected side • Patient may rotate…
