92 Torsion dystonia (dystonia musculorum deformans) Instruction Look at this patient. Salient features History • Perinatal anoxia, birth trauma or kernicterus • Family history • Drug history (neuroleptics) • The…
25 Pulmonary stenosis Instruction Examine this patient’s heart. Salient features History • Patients may be asymptomatic. • Ask if there is a history of maternal rubella. • Dyspnoea on exertion…
22 Atrial septal defect Instruction Examine this patient’s heart. Listen to her heart. Salient features History Ostium secundum defect (anatomically in the region of the fossa ovalis) • Asymptomatic particularly…
91 Cauda equina syndrome Instruction This patient has bowel and bladder dysfunction; examine the lower limbs. Salient features History • Ask the patient whether there is pain (usually projected to…
89 Tetraplegia Instruction Carry out a neurological examination of this patient’s lower limbs. Salient features History • Ask about bladder symptoms and check sacral sensation • Ask about radicular pain…
87 Winging of the scapula Instruction Look at this patient’s back. Salient features History • Difficulty in raising the arms above the level of the shoulders • Winging of the…
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 •…
86 Wallenberg’s syndrome (lateral medullary syndrome) Instruction Examine this patient’s cranial nerves. Salient features History • Severe nausea, vomiting, nystagmus (involvement of the lower vestibular nuclei) • Limb ataxia (involvement…
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…
