Questions
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0votes
1ans
104
views
Differentiating Alzheimer's disease from vascular dementia — clinical, neuroimaging, and biomarker approach
A 74-year-old hypertensive male presents with a 2-year history of progressive cognitive decline. His deficits began abruptly after a lacunar infarct and have progressed in a stepwi…
0votes
1ans
105
views
CGRP antagonists vs traditional migraine prophylaxis (topiramate, propranolol, amitriptyline) — when to escalate?
A 35-year-old female with chronic migraine (> 15 headache days/month) has failed topiramate and amitriptyline due to side effects. She is now on overusing triptans. What is the cur…
0votes
1ans
117
views
Systematic approach to peripheral neuropathy workup: axonal vs demyelinating, and key treatable causes
A 58-year-old diabetic male presents with bilateral symmetric distal numbness, burning pain, and mild weakness of foot dorsiflexion. EMG/NCS shows predominantly axonal sensorimotor…
0votes
2ans
98
views
Prevention and management of cerebral vasospasm after aneurysmal subarachnoid hemorrhage
A 55-year-old woman with aneurysmal SAH (Hunt-Hess grade 3, Fisher grade 3) had successful coil embolization on day 1. On day 5, she develops new focal deficits and TCD shows eleva…
0votes
0ans
131
views
When to initiate levodopa in Parkinson's disease — early vs delayed treatment debate
A 62-year-old man with newly diagnosed Parkinson's disease presents with mild resting tremor, rigidity, and bradykinesia but is still functionally independent. He asks whether star…
0votes
0ans
142
views
Management of Guillain-Barré syndrome: IVIG vs plasmapheresis, and ICU monitoring criteria
A 30-year-old male presents with ascending weakness starting in the legs, areflexia, and mild respiratory compromise 2 weeks after a campylobacter gastroenteritis. NCS confirms AID…
0votes
1ans
106
views
Headache red flags (SNOOP4) — which patients need urgent neuroimaging?
A 42-year-old woman presents to the ED with a sudden severe headache she describes as the worst of her life, with onset during exercise. No fever, no neck stiffness initially. How …
0votes
0ans
149
views
Key differences between MS and NMOSD: clinical, imaging, and CSF findings
A 28-year-old female presents with bilateral optic neuritis and transverse myelitis extending over 3 vertebral segments. MRI spine shows a long central cord lesion at C3-C6. Serum …
4votes
1ans
120
views
Step-by-step management of refractory status epilepticus in the ICU
A 35-year-old known epileptic presents with continuous tonic-clonic seizure activity lasting > 30 minutes unresponsive to IV lorazepam 4mg and IV levetiracetam 3g. He is now intuba…
0votes
0ans
129
views
Ischemic stroke thrombolysis beyond the 4.5-hour window: who qualifies with advanced imaging?
A 67-year-old patient woke up with right-sided hemiparesis and aphasia. Time last known well is 9 hours ago. NIHSS is 12. MRI DWI shows small core infarct with large penumbra on pe…
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