Neurology confusion pairs
41 Neurology topics students commonly mix up on Step 1, each with the fastest separator, a side-by-side comparison, and a free practice question.
- Myasthenia gravis vs Lambert-Eaton syndromeMG worsens with use and is postsynaptic; Lambert-Eaton has post-exercise facilitation and is presynaptic.Video
- Multiple sclerosis vs Neuromyelitis opticaMS is multifocal CNS demyelination; NMO is optic-spinal disease with AQP4 association and long cord lesions.Video
- Ischemic stroke vs Hemorrhagic strokeIschemic stroke: deficit with a normal early noncontrast CT; hemorrhagic stroke: deficit with headache, vomiting, and hyperdense blood on…Video
- Bacterial meningitis vs Viral meningitisBacterial CSF is neutrophilic with low glucose; viral CSF is lymphocytic with normal glucose.Video
- BPPV vs Meniere diseaseBPPV: seconds of position-triggered vertigo with normal hearing; Meniere: episodic vertigo with hearing loss, tinnitus, and aural fullness.Video
- Parkinson disease vs Essential tremorParkinson tremor is resting plus bradykinesia; essential tremor is action/postural without bradykinesia.Video
- Upper motor neuron lesion vs Lower motor neuron lesionUMN lesion: spastic weakness, hyperreflexia, upgoing Babinski, no atrophy; LMN lesion: flaccid weakness, hyporeflexia, atrophy,…Video
- HSV encephalitis vs Bacterial meningitisHSV encephalitis: fever with cortical signs and temporal lobe MRI changes; bacterial meningitis: fever with neck stiffness and…Video
- Epidural hematoma vs Subdural and subarachnoid hemorrhageEpidural is a lens that does not cross sutures but can cross midline; subdural is a crescent that crosses sutures but not the falx;…Video
- Embolic and thrombotic ischemic stroke vs Lacunar strokeLarge-vessel stroke has cortical territory clues; lacunar stroke has small deep pure deficits without cortical signs.
- MCA stroke vs ACA and PCA strokesMCA: face and arm weakness with aphasia or neglect; ACA: leg weakness; PCA: homonymous hemianopia with macular sparing.Video
- Transient ischemic attack vs StrokeTIA is transient focal deficit without infarction; stroke is neurologic deficit with tissue injury.Video
- Migraine vs Tension and cluster headacheMigraine is throbbing nausea/light sensitivity; tension is bilateral pressure; cluster is unilateral orbital autonomic pain.
- Pseudotumor cerebri vs Brain tumorPseudotumor is high ICP with normal imaging and normal CSF contents; brain tumor is high ICP or deficits with a mass lesion.
- Meningitis vs EncephalitisMeningitis: fever and neck stiffness with intact cortical function; encephalitis: fever with altered mental status, seizures, and focal…
- Dementia with Lewy bodies vs Parkinson disease dementia and Alzheimer diseaseDLB is dementia plus hallucinations/fluctuations early; PDD is Parkinson first then dementia; Alzheimer is memory-first dementia.
- Alzheimer and vascular dementia vs Lewy body and frontotemporal dementiaAlzheimer is memory-first gradual; vascular is stepwise stroke-linked; Lewy is hallucination/fluctuation; frontotemporal is…
- Normal pressure hydrocephalus vs Alzheimer diseaseNPH is gait plus bladder plus cognition with big ventricles; Alzheimer is memory-first gradual neurodegeneration.
- Creutzfeldt-Jakob disease vs Other dementiasCJD is rapid dementia with myoclonus/prion clues; other dementias have slower or domain-specific patterns.
- Huntington disease vs Wilson disease and Sydenham choreaHuntington is adult AD chorea-dementia; Wilson is copper/liver/KF rings; Sydenham is post-strep child chorea.
- ALS vs Polio and spinal muscular atrophyALS is adult mixed UMN/LMN motor degeneration; polio is infectious LMN paralysis; SMA is infant genetic anterior horn disease.
- Friedreich ataxia vs Vitamin E deficiency and subacute combined degenerationFriedreich is inherited early ataxia plus cardiomyopathy; vitamin E is deficiency mimic; B12 SCD is posterior column/lateral tract myelin…
- Tabes dorsalis vs Subacute combined degeneration and Friedreich ataxiaTabes is neurosyphilis dorsal columns/roots; SCD is B12 posterior plus lateral columns; Friedreich is inherited early ataxia with…
- Brown-Sequard syndrome vs Anterior, central, and posterior cord syndromesBrown-Sequard is hemicord split findings; anterior is motor plus pain/temp bilaterally; central is arms/cape; posterior is dorsal-column…
- Cauda equina syndrome vs Conus medullaris syndromeCauda equina is painful asymmetric nerve roots; conus is early symmetric sphincter/perianal cord-level dysfunction.Video
- Syringomyelia vs Multiple sclerosisSyringomyelia is central cord cape-like dissociated sensory loss; MS is disseminated CNS demyelination in time and space.
- Bell palsy vs Stroke facial weaknessBell palsy affects the whole ipsilateral face; stroke usually spares the forehead and brings other UMN/cortical signs.Video
- Trigeminal neuralgia vs Cluster headache and temporal arteritisTrigeminal neuralgia is triggerable electric facial pain; cluster is orbital autonomic headache; temporal arteritis is older patient with…
- Horner syndrome vs Third nerve palsyHorner is small pupil plus mild ptosis; third nerve palsy is big pupil or down-and-out ophthalmoplegia plus ptosis.Video
- Internuclear ophthalmoplegia vs Sixth nerve palsyINO is adduction failure with preserved convergence; sixth nerve palsy is abduction failure.
- Wernicke encephalopathy vs Korsakoff syndromeWernicke is acute confusion-eye-ataxia emergency; Korsakoff is chronic amnesia-confabulation sequela.Video
- Wernicke and Broca aphasia vs Conduction aphasiaWernicke is fluent but does not understand; Broca understands but cannot speak fluently; conduction understands and speaks fluently but…
- Delirium vs Dementia and depressionDelirium is acute fluctuating inattention; dementia is chronic decline; depression is mood syndrome that can look cognitively slowed.
- Absence seizures vs Focal and generalized tonic-clonic seizuresAbsence is brief generalized pause with 3-Hz spike-wave and no postictal state; focal seizures have focal onset/aura; tonic-clonic has…
- Simple febrile seizure vs MeningitisSimple febrile seizure is brief generalized fever seizure with quick baseline return; meningitis is fever seizure with meningeal or…
- Myoclonic and atonic seizures vs Tonic-clonic seizuresMyoclonic and atonic seizures are brief with little postictal state; tonic-clonic seizures have tonic-then-clonic phases and prolonged…
- Status epilepticus vs Single self-limited seizureStatus is 5 minutes or repeated without recovery; single seizure ends and the patient returns toward baseline.
- Glioblastoma vs Meningioma and schwannomaGlioblastoma is infiltrative necrotic astrocytoma; meningioma is dural whorls/psammoma; schwannoma is nerve sheath Antoni/Verocay.
- Medulloblastoma vs Ependymoma and pilocytic astrocytomaMedulloblastoma is malignant vermis small-blue-cell with drop mets; ependymoma is ventricular pseudorosettes; pilocytic astrocytoma is…
- Craniopharyngioma vs Pituitary adenomaCraniopharyngioma is calcified cystic suprasellar Rathke remnant; pituitary adenoma is sellar hormone-producing or compressive adenoma.Video
- Pseudobulbar palsy vs Bulbar palsyPseudobulbar is UMN bulbar with brisk jaw/emotional lability; bulbar is LMN bulbar with atrophy/fasciculations.
Medicine Explained
Plain-language explainers on the physiology behind neurology.