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How good at neurology are you? — Questions

1. Consider the following and examine the image to explain the mechanism of this facial numbness

Intensive care staff ask you to see a pregnant woman who has been attacked by a knife wielding assailant. She complains of a unilateral numb face and has had treatment for a haemopneumothorax. You identify an artifical right eye, facial bruising and lacerations, complete unilateral left trigeminal anaesthesia, and blood behind the left ear drum, but no other neurological signs. You request a brain CT scan.

Andrew Chancellor, New Zealand

2. Read the stem

A 62 year old man first noted weakness and wasting of the muscles of his hands when aged 22. When 35 years old he had weakness of eye closure and impaired pain and temperature sensation throughout his body, except for the distal parts of his legs. Vibration and position sense were both normal. Weakness and wasting progressed very slowly in . . . [Full text of this article]