Neuro Signs

Question 1

Relative afferent pupillary defect

Answer 1

Marcus-Gunn pupil

Question 2

Electric shock/paresthesia when neck is flexed or extended

Answer 2

Lhermitte’s sign

Question 3

Hips and knees flex during passive neck flexion

Resistance to straightening the flexed knee

Answer 3

Brudzinski/Kernig’s sign

Indicates meningeal irritation

Question 4

Percussion at the wrist–>paresthesia in the median nerve distribution

Answer 4

Tinel’s sign

Entrapment neuropathy

Question 5

Flexion of the thumb (rather than adduction) when pulling a piece of paper between the thumb and index finger

Answer 5

Froment’s sign

Ulnar nerve lesion

Question 6

Limitation of leg raise to 45-60 degrees

Answer 6

Straight-leg raise test

Nerve root compression

Question 7

Pressing the heel on the opposite knee causes pain in the hip region

Answer 7

Patrick’s sign

Sacroiliac joint disease

Question 8

Arm drift with pronation

Answer 8

UMN lesion

Question 9

Transient hemiparesis after focal motor seizure

Answer 9

Todd’s paralysis

Question 10

Move the head around and look for nystagmus

Answer 10

Hallpike sign
Inner ear disease–fatigable vertigo and nystagmus after a few seconds
Central lesion–immediate, nonfatigable nystagmus

Question 11

Retention of pupillary reaction to light in the presence of ptosis and eye movement abnormalities

Answer 11

Ischemic CNIII palsy (diabetes and HTN)

Not seen in compressive CNIII palsy

Question 12

Tapping thumb with index finger causes other fingers to move synchronously

Answer 12

Fisher’s sign

Lack of other finger movement–>corticospinal tract lesion

Question 13

Rapidly rolling one arm around the other

Answer 13

Subtle pyramidal tract lesion

Question 14

Speed of foot tapping

Answer 14

Slow tapping–UMN lesion

Question 15

Contralateral lid droops when opening or closing the ptotic lid

Answer 15

Herring phenomenon

Myasthenia gravis

Question 16

Vision loss after a hot shower

Answer 16

Uhthoff’s sign

Optic nerve demyelination