PACES MRCP UK - Where MRCPians Meet Since 2006

MRCP is well establised as an entry exam for advanced specialist training in many countries including Malaysia. It consists of 3 paper i.e. Part1, Part2(written tests) and PACES. PACES in full means Practical Assessment of Clinical Examination Skills. It is the third part and the candidate is assessed by fellows of RCP. I passed my PACES in 2005. I am glad that many seniors had guided me throughout my preparation for PACES and I wish to share my experiences with PACES candidates via this blog.


Sunday, July 23, 2006

Brown Sequard Syndrome



I am now working in neurology unit. Hence, I will be showing you all more neurology cases. Recently, I came across a case of SLE who presented to us with subacute onset of right LL weakness. Clinically, she has monoparesis of right leg with reduced tone, the reflexes are reduced and extensor plantar response. There is loss of joint position and vibration senses on the right side. There is loss of pain senses on the left side up to the level of T7.

These features suggest a diagnosis of right hemisection of the spinal cord. An urgent MRI of spine is warranted to exclude space occupying lesion like abscess or tumour.

Our working diagnosis is tranverse myelitis related to SLE.
The diffential diagnosis would include tumor (primary or metastatic), disk herniation, herniation of the spinal cord through a dural defect, epidural hematoma and vertebral artery dissection.

More about Charles-Édouard Brown-Séquard .

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6 Comments:

At 7/27/2006 02:58:00 AM, Blogger Rontol said...

Err can you check my brain??
just in case if i've that syndrome ehehe :p

 
At 8/07/2006 01:47:00 AM, Blogger saramin said...

We would like to know the results of her investigations, especially, her MRI..

 
At 8/07/2006 10:19:00 AM, Blogger eMRCPian said...

Her MRI show hyperintensity areas over T1-T9 in T2W setting.

 
At 8/11/2006 03:30:00 AM, Blogger saramin said...

Althoguh the MRI findings are too short listed and without a pic, they dont correlated with the clinical findings of BSS...

 
At 8/11/2006 03:31:00 AM, Blogger saramin said...

correlate*

 
At 11/08/2008 03:55:00 AM, Anonymous drrizvanahmed said...

hyperintense lesions in T2 sequences may be dueto multiple sclerosis

 

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