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How Good at Neurology are you? – Answers

New Zealand

EXTRACT

1. (c) is false

Overweight patients like this man with pain, are more likely than matched, non-neuropathy controls, to show impaired glucose tolerance (see Hughes et al. in Brain 2004, 127, 1723–30). This is less likely when the neuropathy is painless. Impaired glucose tolerance is usually defined by glucose levels of 7.8–11 mmol/L 2 hours after a 75g oral glucose load. The fasting insulin concentration is also likely to be elevated. After adjusting for body mass index, hypertriglyceridaemia not linked to diabetes mellitus, is more likely in patients than controls, suggesting a ‘metabolic’ basis to chronic axonal polyneuropathy, which is not a direct consequence of hyperglycaemia per se.

2. (a) and (d) are true

Information on pergolide associated valvular heart disease is evolving. A high prevalence (> 40%) of ‘serious’ valve disease has recently been described in an echocardiographic case-control study (Neurology 2004, 63, 301–4). It seems ...

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