Case 1 Case 2 Case 3 Case 4

Onset After the fall 1 month ago Few weeks Rapid onset
before admission
Conscious level Can’t remember Coping well Coping well Getting confused
anything, disoriented
Motor deficit  power: 3/5  Choking on  Upper limb:  Cranial
power in right food and mild nerves: right
shoulder difficulty weakness of nasolabial
abduction, swallowing left triceps fold
limited by severe (dysphagia) and left flattened.
pain; 5/5 power  Unsteady finger Dribbling of
in all other gait extension. saliva from
muscle groups  Drooping on Reduced left right corner
bilaterally right side of triceps reflex of mouth.
face  Lower limb: No voluntary
- abnormal flexion  Exaggerated increased movement
to pain reflexes on muscle tone on lower
left knee, in left leg. right face.
ankle, arm Moderate  Upper limb:
 Clumsiness weakness of complete
of left finger left lower paralysis of
movement limb right (only
 Increased movements flicker in
tone in left at hip, knee, biceps and
leg ankle and triceps)
 toes. Brisker  Lower limb:
left knee jerk can partially
and ankle flex right hip
jerk reflexes. and knee.
Babinski (+) Cannot lift
straightened
right leg off
bed. Weak
dorsiflexion
of right foot
Sensory deficit  numbness in right  Numbness Reduced No respond to
upper arm and tingling sensation to touch on right
 reduced on right pinprick over face
sensation over cheek CN5 right lower limb
the lateral  Reduced and trunk
portion of his corneal extending
right arm reflex, approximately to
 diffuse blinking, the level of the
tenderness over reduced pain axilla.
hid right shoulder and Temperature
on palpation, an sensation on sensation
area of focal RHS reduced over a
tenderness  No sensation similar
cannot be on the right distribution.
ascertained for gag reflex Abnormal light
and palate touch sensation
 moves poorly over the left leg
 Loss of pain and trunk, the
and temp axilla, and down
sensation on the medial left
LHS of body arm to include
up to the the ring and little
neck finger. Vibration
 Loss of fine sensation
touch and impaired at left
propriocepti ankle, knee and
on in LHS hip. Position
upper and sense impaired
lower limb in left foot.
Speech changes - incomprehensible Speech No speech Repetitive
sounds difficulties, disturbance speech (aphasia)
change in voice
Visual  no visual Visual acuity left No visual
disturbance disturbances eye 6/36. Right disturbance
 pupil are equal eye reacts
and reactive to sluggishly to
light light. RAPD in
 fundoscopy: right eye. Visual
normal fields decreased
in right eye.
- pupil dilated, Right eye has
does not respond decreased colour
to light perception. Pain
- left pupil in right eye
constrict but right during eye
remains dilated movement
testing
Explanation Epidural hematoma GBM MS Stroke
*”-“  after deteriorate