35 Ebstein’s anomaly Instruction Listen to this patient’s heart. He was told he had an innocent murmur during a school medical examination many years ago but now has a large…

73 Tabes dorsalis Instruction Examine this patient with lightning pains (lightning denotes that the pains are fleeting and does not necessarily mean they are excruciating). Salient features History • ‘Lightening…

81 Internuclear ophthalmoplegia Instruction Examine this patient’s eyes. Salient features History • Diplopia • History of multiple sclerosis • Neurofibroma (causing pontine gliomas) • Drugs (phenytoin, carbamezapine). Examination • Nystagmus…

63 Dermatomyositis Instruction Examine this patient. Salient features History • The adult form usually occurs after the age of 40 years • Weakness of proximal muscles evolving over weeks or…

61 Abnormal gait Instruction Look at this patient walking. Test this patient’s gait. Salient features Examination There are several types of abnormal gait. Keep in mind the phases and pathogenesis…

55 Peripheral neuropathy Instruction Examine this patient’s legs. Carry out a neurological examination of this patient’s legs. Salient features History • Progressive and symmetrical numbness in the hands and feet…

53 Seventh cranial nerve palsy Lower motor neuron type Instruction Look at this patient’s face. Examine the cranial nerves. Salient features History • Onset: whether abrupt followed by worsening over…

76 Carpal tunnel syndrome Instruction Examine this patient’s hands. Salient features History • Ask the patient about nocturnal pain (commonest cause of hand pain at night). Often the pain wakes…

72 Subacute combined degeneration of the spinal cord Instruction Carry out a neurological examination of the patient’s legs. Salient features History • Family history of pernicious anaemia • History of…