OSCE Neurological Assessment 5

Question 1

A patient presents with loss of pain and temperature on the left side of the body and loss of proprioception and vibration on the right side. This crossed sensory pattern is called:

Accepted Answer

Brown-Séquard syndrome

Answer

Brown-Séquard syndrome results from hemisection of the spinal cord, causing ipsilateral proprioception loss (posterior column) and contralateral pain/temperature loss (spinothalamic tract).

Question 2

When assessing the abducens nerve (CN VI), which specific eye movement deficit would you expect with a complete palsy?

Accepted Answer

Inability to abduct the ipsilateral eye (lateral gaze palsy)

Answer

CN VI innervates the lateral rectus muscle; a complete CN VI palsy causes inability to abduct the affected eye, resulting in esotropia (medial deviation) and diplopia on lateral gaze.

Question 3

A 78-year-old patient scores 24/30 on the MMSE. Which interpretation is most accurate?

Accepted Answer

Score in the normal range, no cognitive impairment likely

Answer

An MMSE score of 24-30 is generally considered within the normal range for cognitive function; scores below 24 raise concern for cognitive impairment.

Question 4

During facial nerve (CN VII) examination, you notice the patient cannot close the right eye, has drooping of the right corner of the mouth, and cannot raise the right eyebrow. This pattern indicates:

Accepted Answer

Right lower motor neuron (peripheral) lesion

Answer

Lower motor neuron CN VII lesion causes complete ipsilateral facial weakness affecting both upper and lower face, including forehead; upper motor neuron lesions spare the forehead due to bilateral cortical representation.

Question 5

To assess for an upper motor neuron lesion in the leg, which sign would support this finding?

Accepted Answer

Positive Babinski sign (upgoing plantar response)

Answer

The Babinski sign (upgoing great toe with fanning of other toes on plantar stimulation) indicates an UMN lesion causing disinhibition of primitive reflexes; absent reflexes and flaccidity suggest LMN lesions.

OSCE Practice Test

OSCE Practice Test

OSCE Neurological Assessment 5