Iraqi Board Neurology key terms

Nonfluent language output with effortful, telegraphic speech, relatively preserved comprehension, and impaired repetition, caused by a lesion of the dominant inferior frontal gyrus. Patients are typically aware of their errors.

Fluent speech that is empty or jargon-filled, with poor comprehension and impaired repetition, from a lesion of the dominant posterior superior temporal gyrus. Patients are usually unaware of their deficit and may appear agitated or paranoid.

Fluent speech with normal comprehension but markedly impaired repetition and frequent phonemic paraphasias, caused by a lesion of the arcuate fasciculus connecting temporal and frontal language areas.

Failure to attend or respond to stimuli on the side opposite a lesion, most often after right parietal damage, with left-sided neglect. It is distinct from hemianopia and predicts poor functional recovery.

A tetrad of finger agnosia, right-left disorientation, agraphia, and acalculia, classically from a lesion of the dominant angular gyrus in the inferior parietal lobule.

Findings of corticospinal tract damage: spasticity, hyperreflexia, extensor plantar response, and loss of fine dexterity, with weakness that predominates in distal and antigravity muscles. It indicates a lesion above the anterior horn cell.

Findings of anterior horn cell, root, or peripheral nerve damage: flaccid weakness, atrophy, fasciculation, hyporeflexia, and eventual denervation changes on electromyography. Weakness is often proximal or in a nerve territory.

Extension of the great toe with fanning of the other toes when the lateral sole is stroked, reflecting corticospinal tract dysfunction. It is normal in infants before myelination completes and abnormal thereafter.

Impaired adduction of one eye with abducting nystagmus of the other on horizontal gaze, from a lesion of the medial longitudinal fasciculus. Bilateral cases in a young adult suggest demyelinating disease; unilateral cases in older adults suggest brainstem ischemia.

Conjugate horizontal gaze palsy in one direction plus internuclear ophthalmoplegia on looking to the opposite side, from a unilateral dorsal pontine lesion involving the abducens nucleus or paramedian pontine reticular formation plus the adjacent medial longitudinal fasciculus.

Lateral medullary infarction causing ipsilateral facial numbness, Horner syndrome, ataxia, and dysphagia with contralateral loss of pain and temperature sensation, usually from vertebral or posterior inferior cerebellar artery occlusion.

Midbrain infarction producing ipsilateral third nerve palsy with contralateral hemiparesis, from involvement of the cerebral peduncle and exiting oculomotor nerve, typically due to posterior cerebral artery perforator occlusion.

Quadriplegia and anarthria with preserved consciousness and vertical eye movement, caused by a ventral pontine lesion, most often basilar artery occlusion. Communication is possible through blinking or vertical gaze.

A 15-item clinical score (0-42) quantifying stroke deficit severity across consciousness, gaze, visual fields, motor, sensory, language, and neglect domains. It guides thrombolysis decisions and predicts outcome.

A 10-point CT scoring system for early ischemic change in the middle cerebral artery territory, where one point is subtracted per affected region. Lower scores indicate larger infarction and higher hemorrhage risk after reperfusion.

Mechanical removal of an intracranial clot via catheter, indicated for large vessel occlusion with salvageable tissue, generally within 24 hours when imaging selection criteria are met. It improves functional outcome in selected patients.

Intravenous alteplase or tenecteplase given to eligible patients with acute ischemic stroke, typically within 4.5 hours of onset, after excluding hemorrhage and contraindications. Earlier treatment yields greater benefit.

Deposition of beta-amyloid in cortical and leptomeningeal vessel walls, causing lobar intracerebral hemorrhage, cortical superficial siderosis, and microbleeds in older adults. It is a common cause of recurrent lobar hemorrhage.

Small rounded hypointense foci on susceptibility-weighted or gradient-echo MRI representing hemosiderin from prior small vessel bleeding. Lobar distribution suggests amyloid angiopathy; deep distribution suggests hypertensive arteriopathy.

A continuous seizure lasting five minutes or more, or repeated seizures without recovery of consciousness between them, requiring immediate benzodiazepine therapy and a search for the underlying cause.

A generalized epilepsy syndrome beginning in adolescence with morning myoclonic jerks, occasional generalized tonic-clonic seizures, and sometimes absence seizures. The EEG shows 3-6 Hz generalized spike-wave discharges; it persists lifelong.

Recording of scalp electrical potentials to detect epileptiform discharges, encephalopathy patterns, or cerebral death. Activation by hyperventilation, photic stimulation, and sleep deprivation increases sensitivity for epilepsy.

Electrical stimulation of a nerve with recording of the evoked response to measure latency, amplitude, and conduction velocity. It distinguishes axonal loss from demyelination and localizes focal entrapment.

Needle recording of muscle electrical activity at rest and during voluntary contraction, showing fibrillation potentials, fasciculations, myopathic units, or neurogenic recruitment. It complements nerve conduction studies in neuromuscular diagnosis.

An acute immune-mediated polyradiculoneuropathy presenting with ascending symmetric weakness and areflexia, often after infection. Cerebrospinal fluid shows albuminocytologic dissociation; treatment is intravenous immunoglobulin or plasma exchange.

A progressive or relapsing demyelinating neuropathy lasting more than eight weeks, with proximal and distal weakness, areflexia, and conduction block on nerve conduction studies. It responds to immunomodulatory therapy.

Autoimmune blockade of postsynaptic acetylcholine receptors causing fatigable ptosis, diplopia, bulbar weakness, and proximal limb weakness. Repetitive nerve stimulation shows decrement; treatment includes pyridostigmine and immunosuppression.

Antibodies against presynaptic voltage-gated calcium channels causing proximal leg weakness, autonomic symptoms, and hyporeflexia that improves after exercise. It is often paraneoplastic, associated with small cell lung cancer.

An immune-mediated demyelinating disease of the central nervous system producing relapses disseminated in time and space. MRI shows periventricular, juxtacortical, infratentorial, and spinal cord lesions; oligoclonal bands appear in cerebrospinal fluid.

An astrocytopathy caused by antibodies to aquaporin-4, producing severe optic neuritis and longitudinally extensive transverse myelitis. It often spares the brain and requires different immunotherapy from multiple sclerosis.

Coma and encephalopathy in a patient with Plasmodium falciparum parasitemia, often with seizures and retinal changes. It is a medical emergency requiring parenteral artesunate; mortality remains high without prompt treatment.

Subacute meningitis with fever, headache, and progressive cranial nerve palsies, showing basal meningeal enhancement and hydrocephalus. Cerebrospinal fluid has raised protein, low glucose, and lymphocytic pleocytosis; treatment is prolonged antituberculous therapy with steroids.

The most common malignant primary brain tumor in adults, an IDH-wildtype astrocytoma with necrosis and microvascular proliferation. It presents with seizures or focal deficit and is treated with surgery, radiotherapy, and temozolomide.

A usually benign extra-axial tumor arising from arachnoid cap cells, appearing as a dural-based enhancing mass with a tail. It causes symptoms by compression and is treated with observation or surgical resection.

New or enlarging contrast enhancement on MRI shortly after chemoradiotherapy that reflects treatment-related inflammation rather than tumor growth, often settling without change in therapy. It complicates response assessment in glioma.

Involuntary choreiform or dystonic movements appearing at peak levodopa effect in advanced Parkinson disease, reflecting altered striatal dopamine handling. Management includes dose adjustment and deep brain stimulation.

A progressive neurodegenerative disorder with bradykinesia, rigidity, resting tremor, and postural instability, due to loss of nigrostriatal dopaminergic neurons with Lewy bodies. Nonmotor features include anosmia, constipation, and REM sleep behavior disorder.

An atypical parkinsonian tauopathy with vertical supranuclear gaze palsy, early falls, axial rigidity, and poor levodopa response. MRI may show midbrain atrophy, the hummingbird sign.

The commonest cause of dementia, with progressive episodic memory loss from amyloid plaques and tau tangles in medial temporal and neocortical regions. MRI shows hippocampal atrophy; biomarkers include low cerebrospinal fluid amyloid-beta and raised tau.

A neurodegenerative syndrome with behavioral change or language impairment from frontal and temporal atrophy, often presenting before age 65. It overlaps with motor neuron disease and is associated with tau, TDP-43, or FUS pathology.

Recurrent attacks of reversible focal neurological symptoms, usually visual, developing gradually over minutes and followed by headache. It is distinguished from transient ischemic attack by symptom spread and stereotyped recurrence.

Severe strictly unilateral orbital pain with ipsilateral autonomic features such as lacrimation and ptosis, occurring in bouts of short attacks. High-flow oxygen and subcutaneous sumatriptan are acute treatments.

Brief electric shock-like unilateral facial pain in a trigeminal division, triggered by touch or chewing. Neurovascular compression is common; carbamazepine is first-line, and microvascular decompression is definitive.

An X-linked recessive dystrophinopathy causing progressive proximal weakness in boys from early childhood, with calf pseudohypertrophy and elevated creatine kinase. Cardiomyopathy and respiratory failure determine prognosis.

An autosomal dominant disorder from NF1 mutation causing cafe-au-lait macules, neurofibromas, axillary freckling, optic pathway glioma, and Lisch nodules. It is a classic neurocutaneous syndrome requiring surveillance.

A seizure with fever in a child aged 6 months to 5 years without central nervous system infection or prior afebrile seizures. Simple febrile seizures are brief and generalized and carry low epilepsy risk.

A nonprogressive disorder of movement and posture from injury to the developing brain, often with spasticity, dystonia, and associated epilepsy or visual problems. Causes include prematurity and perinatal hypoxia-ischemia.