Archives for 2019

Neuro-ophthalmology Illustrated Chapter 12 – The Pupil 1

Questions:
1. When examining the pupils, what 6 items should be recorded?
2. Does a relative afferent pupillary defect cause anisocoria?
3. If there is no relative afferent pupillary defect in a patient is suspected of having optic neuropathy (regardless of the cause) does that rule-out this diagnosis?
4. If a patient has severe bilateral optic neuropathy will the pupils respond to near stimuli?

Neuro-ophthalmology Illustrated Chapter 11 – Abnormal Visual Perceptions: Hallucinations and Illusions 4

Questions:
42. What are the common hallucinogens?
43. What common hallucinogen can be responsible for delayed impressions of déjà vu or flashbacks that may occur years after even a single-use?
44. Are all anticholinergic agents (including atropine, scopolamine, and cyclopentolate) hallucinogens?
45. What antiparkinsonian agents can cause hallucinations?
46. Can antidepressants cause hallucinations?
47. Can antipsychotics cause hallucinations?
48. What is the visual symptom of toxic levels of Digoxin?
49. Can erectile dysfunction medications cause hallucinations?
50. Can withdrawal from benzodiazepines produce hallucinations?

Neuro-ophthalmology Illustrated Chapter 11 – Abnormal Visual Perceptions: Hallucinations and Illusions 3

Questions:
26. What is palinopsia?
27. What is polyopia?
28. Does the diplopia of polyopia resolve with the closing of either eye?
29. Does the diplopia of polyopia improve with pinhole glasses?
30. What is dysmetropsia?
31. What is the Alice in Wonderland syndrome?
32. What is visual allesthesia?
33. What lesion is most often seen in visual allesthesia?
34. What is the Riddoch Phenomenon?
35. What is Blindsight?
36. What is Residual Vision?
37. What may cause blindsight and residual vision?
38. What are the characteristics of the sensation of environment tilt?
39. What 5 conditions are associated with oscillopsia?
40. What is the Anton Syndrome?
41. What is postoperative delirium?

Neuro-ophthalmology Illustrated Chapter 11 – Abnormal Visual Perceptions: Hallucinations and Illusions 2

Questions:
13. Is the visual aura of migraine a hallucination?
14. What is the typical duration of the visual aura episodes of migraine?
15. What are the characteristics of recurrences of the visual aura of migraine?
16. What is the typical duration of the visual phenomenon of occipital seizures?
17. What other neurologic symptoms can migraineurs have?
18. Are migraineurs aware that the images they see are not real?
19. Can migraineurs experience distortion of images?
20. How are occipital seizures frequently described?
21. What are the characteristics of recurrences of occipital seizures?
22. What is peduncular hallucinosis?
23. What lesion is most often related to peduncular hallucinosis?
24. What are the common visual symptoms of narcolepsy?
25. What is the classic tetrad of narcolepsy?

Neuro-ophthalmology Illustrated Chapter 11 – Abnormal Visual Perceptions: Hallucinations and Illusions 2

Questions:
13. Is the visual aura of migraine a hallucination?
14. What is the typical duration of the visual aura episodes of migraine?
15. What are the characteristics of recurrences of the visual aura of migraine?
16. What is the typical duration of the visual phenomenon of occipital seizures?
17. What other neurologic symptoms can migraineurs have?
18. Are migraineurs aware that the images they see are not real?
19. Can migraineurs experience distortion of images?
20. How are occipital seizures frequently described?
21. What are the characteristics of recurrences of occipital seizures?
22. What is peduncular hallucinosis?
23. What lesion is most often related to peduncular hallucinosis?
24. What are the common visual symptoms of narcolepsy?
25. What is the classic tetrad of narcolepsy?

Neuro-ophthalmology Illustrated Chapter 11 – Abnormal Visual Perceptions: Hallucinations and Illusions 1

Questions: 1. What is the difference between hallucination and illusion?
2. Are isolated visual hallucinations common in psychiatric disorders?
3. Are psychiatric hallucinations associated with altered mental status or focal neurologic signs?
4. Are phosphenes seen in patients with optic neuropathies?
5. What is the Pulfrich phenomenon?
6. In what conditions is the Pulfrich phenomenon seen?
7. What is the Charles Bonnet syndrome?
8. Can encephalopathies or focal cerebral lesions cause hallucinations and illusions?
9. Can confusion and dementia cause visual hallucinations and illusions?
10. Is Lewy body dementia commonly associated with visual hallucinations or illusions?n
11. Which dementias may be associated with paranoid hallucinations and illusions?
12. Can the drugs that are used to treat Parkinson disease cause hallucinations?

Neuro-ophthalmology Illustrated Chapter 10 – Specific Disorders of Higher Cortical Function 8

Questions:
61. What are the clinical characteristics of posterior cortical atrophy?
62. What are the neuroimaging findings in posterior cortical atrophy?
63. What are common etiologies of posterior cortical atrophy?
64. What visual difficulties are commonly seen in Alzheimer disease?
65. What are the neuroimaging findings in Alzheimer disease?
66. What are the OCT findings in  Alzheimer disease?
67. What visual difficulties are commonly seen in the Heidenhain variant of sporadic Creutzfeldt-Jakob disease?

Neuro-ophthalmology Illustrated Chapter 10 – Specific Disorders of Higher Cortical Function 7

Questions:
44. Where is the lesion usually located in the Balint Syndrome?
45. What are the findings of the Balint Syndrome?
46. What is the Gerstmann syndrome and where is its lesion?
47. Where the lesion is usually located in Hemineglect?
48. Are patients with Hemineglect aware of their defect?
49. Are patients with Hemianopia aware of their defect?
50. What is the response when a patient with a left homonymous hemianopia with unilateral spatial neglect is asked to bisect a line?
51. What is the response when a patient with a right homonymous hemianopia without unilateral spatial neglect is asked to bisect a line?
52. What is the response when a patient with a left Hemianopia with unilateral spatial neglect is asked to draw a clock?
53. What is the response when a patient with a right Hemianopia without unilateral spatial neglect is asked to draw a clock?
54. In a patient with left homonymous hemianopia with unilateral spatial neglect is the exploration of space increased or decreased?
55. In a patient with right homonymous hemianopia without unilateral spatial neglect is the exploration of space increased or decreased?
56. In a patient with left homonymous hemianopia with unilateral spatial neglect are contralesional saccades increased or decreased?
57. In a patient with right homonymous hemianopia without unilateral spatial neglect are contralesional saccades increased or decreased?
58. What differences will be observed between hemineglect and hemianopia in searching for objects?
59. What are the differences between lesion location of hemineglect and hemianopia?
60. What are common factors in cerebral disturbances of vision?

Neuro-ophthalmology Illustrated Chapter 10 – Specific Disorders of Higher Cortical Function 6

Questions:
38. What is ocular apraxia?
39. How does one test for ocular apraxia?
40. What clinical signs are associated with ocular apraxia?
41. What is optic ataxia (visuomotor ataxia)?
42. How does one test for optic ataxia?
43. What clinical signs are associated with optic ataxia?

Neuro-ophthalmology Illustrated Chapter 10 – Specific Disorders of Higher Cortical Function 5

Questions:
31. What is akinetopsia?
32. How does one test for akinetopsia?
33. Where is the lesion in akinetopsia?
34. What is simultagnosia?
35. How does one test for simultagnosia?
36. What clinical signs are associated with simultagnosia?
37. Where is the lesion in simultagnosia?