Neurology Resident and Fellow Section

Slides:

Advertisements

Similar presentations

Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology A 74 year-old woman with cerebral edema after myelography.

Advertisements

63 year-old woman with subacute parkinsonism Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology.

Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology A 68 year old woman with transient ptosis on awakening.

A 56-year-old man with intense facial pain Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology.

A 41 year old African patient with „multifocal neurology“ Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology.

A 52-year old man with recently diagnosed HIV infection with irregular shaking of his hand Teaching NeuroImages Neurology Resident and Fellow Section ©

A TWO YEAR OLD GIRL WITH PROGRESSIVE WEAKNESS Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology.

Teaching NeuroImages Neurology Resident and Fellow Section A 57-year-old woman with blurred vision © 2014 American Academy of Neurology.

Acute neck pain and quadriparesis An 82 year old man with acute neck pain Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy.

A 48-year-old man with ptosis and limitation of elevation in the left eye © 2014 American Academy of Neurology Teaching NeuroImages Neurology Resident.

A 68 year old woman with a troublesome chin tremor Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology.

Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology.

84 year old woman with spells of right upper limb weakness and numbness Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy.

A patient with red dot on the forehead A 32-year old woman presented with red dot on her forehead and eyelid ecchymosis Teaching NeuroImages Neurology.

Teaching NeuroImages An 83-year-old woman with phonatory breaks and left hand rest tremor Neurology Resident and Fellow Section © 2013 American Academy.

Neurology Resident and Fellow Section 40 year old woman with left arm pain, numbness, and weakness Teaching NeuroImages © 2013 American Academy of Neurology.

A 43-year-old man with decreased consciousness Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology.

Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology A 35-year-old woman with headache and diplopia.

Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology A 14 year old male with headache and neck stiffness.

A 38-year-old patient with partial seizures Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology.

A woman with multiple mononeuropathies and eosinophilia Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology.

A 53-year-old man with abrupt hearing loss Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology.

47-year-old with progressive upper limb weakness Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology.

A 30-year male with cognitive decline and unsteady gait Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology.

Teaching NeuroImages 50 year old woman underwent therapeutic hypothermia after a witnessed cardiac arrest Teaching NeuroImages Neurology Resident and Fellow.

A 39-year old man with facial diplegia Teaching NeuroImages Neurology Resident and Fellow Section Campbell J, et al © 2013 American Academy of Neurology.

Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology A 23 month old full term male with seizures.

68 year old man with aphasia and facial droop © 2014 American Academy of Neurology Teaching NeuroImages Neurology Resident and Fellow Section.

Teaching NeuroImages A 54-year-old man with progressive muscle weakness, hand tremor, tongue and perioral fasciculation Neurology Resident and Fellow Section.

A 22 years old man with slow movements and mounding phenomenon © 2013 American Academy of Neurology Teaching NeuroImages Neurology Resident and Fellow.

A 26 year old woman with headache, diplopia, and pulsatile tinnitus Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy.

40 year old male with shooting type of pain in the lower leg Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology.

67-old man with 45-min onset left hemiparesis Teaching NeuroImages Neurology Resident and Fellow Section © 2015 American Academy of Neurology.

A 45 year old man with painful right eye blindness Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology.

A 4 Year Old Boy With Proptosis of Left Eye Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology.

23 yo man with left buttock pain Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology.

A 71 year old man with rapid onset of anterograde amnesia Teaching NeuroImages Neurology Resident and Fellow Section © 2015 American Academy of Neurology.

Teaching NeuroImages Neurology Resident and Fellow Section © 2015 American Academy of Neurology A two month old male infant presented with macrocephaly.

Teaching NeuroImages Neurology Resident and Fellow Section A 51 year old female with intermittent left hand numbness and weakness. © 2013 American Academy.

Teaching NeuroImages 38 years old female with leg pain and weakness Neurology Resident and Fellow Section.

Teaching NeuroImages Neurology Resident and Fellow Section Spherules in Spine: Vertebral Coccidioidomycosis © 2014 American Academy of Neurology.

Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology Two sisters with scapular winging.

A 36 year old woman with diplopia Teaching NeuroImages Neurology Resident and Fellow Section © 2015 American Academy of Neurology.

Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology 57-year-old man with a painful tumoral mass in the leg.

A 58 year old woman with acute-onset paresthesias

Patient with painful ophthalmoplegia after traffic accidents

Neurology Resident and Fellow Section

Resident and Fellow Section

A 54-year-old man with acute-onset diplopia and weakness

A 71-YEAR-OLD FEMALE WITH MULTIPLE CRANIAL NERVE PALSIES

Hemigeographic tongue following an acute ischemic stroke

Teaching Video NeuroImages Neurology Resident and Fellow Section

A 41-year-old man with progressive quadriparesis

Progressive jerky movements in a 58 year old man

Resident and Fellow Section

A 39-year old woman with asymmetric facial flushing

Rupture and spontaneous resolution of a P1 perforator pseudoaneurysm

A 29-year-old HIV infected man with right eye-lid ptosis and diplopia

68-year-old patient with memory impairment

A 30 year old male presenting with involuntary oral movements

Neurology Resident and Fellow Section

Acute bilateral ptosis in an 82-year old man

A 45 YEAR OLD WOMAN WITH PROGRESSIVE WEAKNESS

20 year old man with multiple strokes territories

Neurology Resident and Fellow Section

A 45 year-old man with a pathognomonic dyskinesia

Neurology Resident and Fellow Section

A 2 year old girl with progressive neurological deficits

Teaching NeuroImages Neurology Resident and Fellow Section

A 3-year-old boy with increased head circumference

Presentation transcript:

Neurology Resident and Fellow Section sucking candy sign in Bell’s palsy Teaching NeuroImages Neurology Resident and Fellow Section © 2017 American Academy of Neurology

Vignette A 20-year-old woman presented with spontaneous onset of facial weakness. Examination revealed House-Brackmann grade IV1 right facial paresis and a contralaterally pigmented tongue (Figure) from habitual sucking candy use. Contemporaneous taste loss on the anterior right tongue led her to keep the candy as far away from that area as possible – the posterior left tongue. Armand et al. © 2017 American Academy of Neurology

Imaging Armand et al. Figure. Photograph of patient’s face and mouth Photograph of the patient’s upper face demonstrates a lack of brow wrinkles (A) on the right. A photograph of her mouth (B) demonstrates sucking candy pigment deposition on the posterior aspect of the left tongue. Armand et al. © 2017 American Academy of Neurology

sucking candy sign in Bell’s palsy Bell’s palsy can feature taste loss in the anterior two-thirds of the tongue ipsilateral to facial weakness, localizing to a lesion in the infrastapedial- suprachordal segment of the facial nerve. The loss of taste does not correlate with the severity of weakness.2 References 1. House JW, Brackmann DE. Facial nerve grading system. Otolaryngol Head Neck Surg 1985;93:146-147. 2. Seok JI, Lee DK, Kim KJ. The usefulness of clinical findings in localising lesions in Bell's palsy: comparison with MRI. Journal of neurology, neurosurgery, and psychiatry 2008;79:418-420. Armand et al. © 2017 American Academy of Neurology