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A patient with an unclear history of epilepsy has an EEG performed. Based on the region of her epileptiform activity, what is the most likely semiology of her clinical seizures?
A 43-year-old man with obesity and hypertension presents with complaints of excessive daytime sleepiness, gasping awakenings, and witnessed periods of not breathing during sleep. A polysomnogram is performed and confirms the presence of sleep-disordered breathing. What feature would point to a central rather than obstructive cause?
Which of the following is the correct order of internal carotid artery segments (from proximal to distal)?
A 67-year-old male with a past medical history of hypertension and diabetes presents with a 5-day history of facial paralysis and an ear rash. The patient states he returned from a 4-day backpacking trip in the Adirondacks 2 weeks ago in upstate New York where he engaged in hiking and freshwater swimming. His temperature is 36.9 °C (98.5°F), pulse is 72/min, and blood pressure is 131/78. Examination reveals an erythematous vesicular rash in the left auditory canal and pinna and drooping of the left face, forehead, and eyelid. A Weber test lateralizes to the right ear and a Rinne test shows air conduction greater than bone conduction in both ears. What is the most likely diagnosis?
A 22-month-old girl presents with her mother for abnormal movements and loss of milestones. The mother describes the patient frequently and repetitively squeezes and twists her hands, and has lost some of her developmental milestones including fine motor skills and verbal speech. She has stopped walking as well. On examination of growth curves, her head circumference percentile appears to have fallen off of the curve. The patient has no other past medical problems, no past trauma, or past infections, and had been developing normally up until now. Of the following, which is most likely true?
A 22-year-old female with chronic daily headaches and other neurological symptoms has an MRI performed as part of her diagnostic workup. Her cervical MRI imaging is provided below. In addition to her chronic daily headaches, what are the most likely additional neurological symptoms she experiences?
A 21-year-old man is brought into the clinic by his roommate due to bizarre behavior. For the last 10 months, the patient has been intermittently skipping classes and trying to soundproof his dorm room because he believes the government is watching him. His roommate says that on two separate occasions he caught the patient talking to himself under the bed covers. The neurological exam is normal but the patient refuses to make eye contact and his speech is pressured and tangential. Which of the following is the most likely diagnosis?
An MRI is performed on a 40-year-old man after experiencing his first unprovoked seizure. The lesion appreciated on the MRI T2 sequence shown below is most likely which of the following?
A 65-year-old woman with a past medical history of hypertension, hyperlipidemia, and migraine headaches previously well-controlled on propranolol, presents to the clinic with new headache characteristics. The patient states that she recently has a new scalp tenderness. On further history, she endorses jaw soreness after eating. What is the most appropriate initial diagnostic test?
A 30-year-old female with a past medical history significant for acne, migraine without aura, and depression presents to the emergency room with severe recurrent headaches. She says the headaches come on quickly and only last a couple of minutes but are debilitating. CTH was normal. A CTA head and neck was performed which showed segmental artery narrowing in the proximal MCA territory. Which of the following medications was the most likely trigger of this patient’s presentation?