OSCE OSCE Neurological Assessment 2

Question 1

When assessing the Babinski sign, which finding is considered abnormal in an adult?

Accepted Answer

Extension of the big toe with fanning of other toes

Answer

In adults, a positive Babinski sign (upgoing plantar reflex) — extension of the hallux with fanning of toes — indicates an upper motor neuron lesion.

Question 2

A patient presents with loss of pain and temperature sensation on the right side of the body and loss of proprioception on the left side. Which spinal cord syndrome does this represent?

Accepted Answer

Brown-Séquard syndrome

Answer

Brown-Séquard syndrome results from hemisection of the spinal cord, causing ipsilateral loss of proprioception and contralateral loss of pain and temperature.

Question 3

During cranial nerve testing, the patient cannot wrinkle the forehead or close the eye on the right side, but facial expression is intact below the eye. Which lesion is most likely?

Accepted Answer

Right lower motor neuron (LMN) lesion

Answer

A right LMN lesion (e.g., Bell's palsy) affects all ipsilateral facial muscles including forehead; UMN spares the forehead due to bilateral cortical representation.

Question 4

Which Romberg test finding indicates a sensory (proprioceptive) rather than a cerebellar ataxia?

Accepted Answer

Ataxia worsens significantly when eyes are closed

Answer

A positive Romberg test (marked worsening with eye closure) indicates reliance on visual compensation for proprioceptive loss, not cerebellar pathology.

Question 5

When testing deep tendon reflexes, a grade of 4+ indicates:

Accepted Answer

Hyperreflexia with clonus

Answer

On the standard 0–4+ scale, 4+ denotes hyperactive reflexes with clonus, suggesting upper motor neuron pathology.

OSCE Practice Test

OSCE Practice Test

OSCE OSCE Neurological Assessment 2