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How Good at Neurology are you? – Questions
  1. Paul Goldsmith*,
  2. Graham Lennox*,
  3. Julian Ray
  1. *Departments of Neurology and
  2. Neurophysiology, Addenbrooke’s Hospital, Cambridge, UK. Email; pg255{at}hermes.cam.ac.uk; drslennox{at}aol.com; j.l.ray{at}medschl.cam.ac.uk

    Abstract

    1. Please consider the following:

    You are asked to review the EEG of a patient on intensive care with unconsciousness of undetermined cause. Full blood count, urea, electrolytes, liver function, calcium, ESR, autoantibodies, chest xray, ECG, CT head scan and CSF all normal.

    What would you suggest to the intensive care physicians?

    1. Carry out brainstem death testing.

    2. Carry out brainstem death testing and contact the transplant team.

    3. Load with phenytoin.

    4. Arrange for a brain biopsy.

    5. Send off urine for toxicology.

    6. Contact the CJD surveillance unit.

    7. Do blood gases.

    2. Please consider the following case:

    An 83 year old man presented to his family doctor with back pain. He had cataracts worse on the left than on the right, was deaf in his right ear and had some urinary hesitancy with poor flow.

    What is the diagnosis ?

    3. Please read the passage below.

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