Neurologists Exam Neurodegenerative & Movement Disorders Flashcards

Which cognitive domain is characteristically impaired earliest in Alzheimer's disease?

Answer: Episodic memory (short-term recall)

Alzheimer's disease typically begins with episodic memory impairment reflecting early hippocampal and entorhinal cortex involvement.

Frontotemporal dementia (FTD) is distinguished from Alzheimer's disease by which early clinical feature?

Answer: Prominent personality and behavioral changes

FTD primarily affects frontal and temporal lobes causing early behavioral disinhibition, apathy, and personality change before significant memory loss.

Progressive supranuclear palsy (PSP) is best characterized by which unique clinical finding?

Answer: Vertical gaze palsy (downgaze) and falls

PSP classically presents with vertical supranuclear gaze palsy (especially downgaze), axial rigidity, and early falls backward.

Cerebellar ataxia, polyneuropathy, and autonomic failure occurring together in a middle-aged adult most suggests which condition?

Answer: Multiple system atrophy (MSA-C)

MSA-C combines cerebellar ataxia with autonomic failure (orthostatic hypotension, bladder dysfunction) reflecting combined olivopontocerebellar and autonomic degeneration.

Which treatment is FDA-approved specifically for chorea in Huntington's disease?

Answer: Tetrabenazine (or deutetrabenazine)

Tetrabenazine (and its deuterated form deutetrabenazine) deplete presynaptic monoamines by inhibiting VMAT2, reducing choreiform movements in HD.

Corticobasal syndrome (CBS) is characterized by asymmetric parkinsonism combined with which distinctive cortical sign?

Answer: Alien limb phenomenon

The alien limb phenomenon—involuntary, goal-directed limb movements that feel foreign to the patient—is a hallmark cortical sign of CBS.