Neurology confusion pairs
20 Neurology topics students commonly mix up on Step 2 CK, each with the fastest separator, a side-by-side comparison, and a free practice question.
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- TIA vs StrokePersistent focal neurologic deficit at evaluation is the immediate branch toward acute stroke treatment.
- Migraine vs Tension headacheNausea or photophobia accompanying headache is the quickest discriminator favoring migraine over tension headache.
- Subarachnoid hemorrhage vs MigraineThunderclap onset to peak intensity within 1 minute.
- Subdural hematoma vs Epidural hematomaCT shape and suture behavior of extra-axial blood.
- Central vertigo vs Peripheral vertigoHINTS examination showing direction-changing or vertical nystagmus.
- Dementia vs DeliriumFluctuating inattention with acute onset identifies delirium.
- Meningitis vs EncephalitisAltered mental status with focal deficits or seizures points to encephalitis.
- Parkinson disease vs Essential tremorRest tremor that fades with voluntary movement points to Parkinson disease.
- Alzheimer disease vs Lewy body dementiaEarly recurrent visual hallucinations with fluctuating attention indicates Lewy body dementia.
- Alzheimer disease vs Frontotemporal dementiaEarly personality or language change with preserved recent-memory recall favors frontotemporal dementia over Alzheimer disease.
- Bacterial meningitis vs Viral meningitisCSF glucose below 40 mg/dL or CSF:serum glucose ratio below 0.4 points to bacterial meningitis.
- Ischemic stroke vs Hemorrhagic strokeImmediate noncontrast head CT evidence of intracranial blood separates hemorrhagic from ischemic stroke.
- Alzheimer disease vs Vascular dementiaStepwise deterioration with focal neurologic findings indicates vascular dementia rather than Alzheimer disease.
- Status epilepticus vs Single seizureSeizure activity lasting longer than 5 minutes defines status epilepticus and mandates emergent treatment.
- Bell's palsy vs StrokeForehead movement, spared forehead suggests stroke while weak forehead indicates Bell's palsy.
- Migraine vs Cluster headacheAttack duration with autonomic signs separates them: 15 to 180 minute unilateral orbital attacks with ipsilateral tearing point to cluster…
- Myasthenia gravis vs Lambert-Eaton syndromeReflexes that are reduced at baseline with post-exercise facilitation point to Lambert-Eaton syndrome over myasthenia gravis.
- Guillain-Barre syndrome vs Myasthenia gravisAbsent deep tendon reflexes in progressive generalized weakness points to Guillain-Barre syndrome rather than myasthenia gravis.
- Cauda equina syndrome vs Conus medullaris syndromeEarly bladder or bowel dysfunction with symmetric saddle anesthesia is the fastest branch point toward conus medullaris syndrome.
- Multiple sclerosis vs Neuromyelitis opticaLongitudinal spinal cord lesion spanning 3 or more vertebral segments with aquaporin-4 positivity identifies NMO over MS.