Neurology

The purpose of the Oral Board Examination is to determine a candidate’s competency in neurosurgical disorders, as well as in neurological disorders which may mimic neurosurgical conditions. Clearly, this goal of the examination process must be kept in the back of an examinee’s mind during questioning. It is not uncommon for a candidate to be presented imaging studies that clearly appear surgical; however, after carefully listening to the history and relevant neurological findings, it will become apparent that the imaging does not explain the patient’s symptoms. When this occurs, start by trying to localize the lesion within the neuraxis—brain, brainstem, spinal cord, peripheral nerve, neuromuscular junction, or the muscle itself. Clues such as hyporeflexia or hyperreflexia and distribution or absence of sensory symptoms are key. Then develop a differential diagnosis of neurological conditions that may present in these areas—vascular, demyelinating, inflammatory, axonal loss, and neuromuscular blockade. Some of the common neurological ailments that the oral board examinee needs to be well aware of include amyotrophic lateral sclerosis, multiple sclerosis, Guillain-Barré syndrome, and Parsonage-Turner syndrome (brachial plexitis), some of which are covered either in this chapter or in other relevant chapters.