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IMF-031-01-0001-en	In what order does neurological diagnosis pose its two core questions, and why can incidental imaging not replace this reasoning?	It first asks where the lesion is, then what process produces it at that speed; coherent localisation guides testing, and an incidental imaging finding never replaces anatomy.	Integrated Medical Foundations; chapter 31, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: e7b0f0365ca2cdb2ed426aa52806d8d373dcae07fb22b818b0e5f598c6a17440; editorial review pending	imf lang::en chapter::031 module::031-01 review::pending
IMF-031-01-0002-en	How does a deficit that is maximal at onset differ in likely mechanism from one that evolves over hours to days?	Maximal deficit at onset suggests embolism, haemorrhage, seizure, migraine or trauma, whereas evolution over hours to days suggests inflammation, infection, infarct progression, metabolic disturbance or compression.	Integrated Medical Foundations; chapter 31, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: e7b0f0365ca2cdb2ed426aa52806d8d373dcae07fb22b818b0e5f598c6a17440; editorial review pending	imf lang::en chapter::031 module::031-01 review::pending
IMF-031-01-0003-en	Why should the clinician ask the patient to describe what failed rather than accept a label such as dizziness?	Labels are ambiguous: dizziness may mean vertigo, presyncope, imbalance or non-specific disequilibrium, and each points to a different mechanism and localisation.	Integrated Medical Foundations; chapter 31, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: e7b0f0365ca2cdb2ed426aa52806d8d373dcae07fb22b818b0e5f598c6a17440; editorial review pending	imf lang::en chapter::031 module::031-01 review::pending
IMF-031-01-0004-en	Which features of an episodic event should a witness description reconstruct?	Posture, prodrome, colour, eye and head movement, motor sequence, responsiveness, duration, injury, tongue biting, recovery and provoking circumstances.	Integrated Medical Foundations; chapter 31, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: e7b0f0365ca2cdb2ed426aa52806d8d373dcae07fb22b818b0e5f598c6a17440; editorial review pending	imf lang::en chapter::031 module::031-01 review::pending
IMF-031-01-0005-en	When red flags such as thunderclap headache, declining consciousness or spinal pain with sphincter disturbance are present, how does the order of assessment change?	Stabilisation and urgent treatment take priority over a leisurely complete examination, because these features signal immediately threatening disease.	Integrated Medical Foundations; chapter 31, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: e7b0f0365ca2cdb2ed426aa52806d8d373dcae07fb22b818b0e5f598c6a17440; editorial review pending	imf lang::en chapter::031 module::031-01 review::pending
IMF-031-01-0006-en	Why are arousal and attention assessed before memory, language and executive testing?	Impaired arousal or attention invalidates downstream cognitive testing, so poor performance on later tasks cannot be interpreted until these are established.	Integrated Medical Foundations; chapter 31, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: e7b0f0365ca2cdb2ed426aa52806d8d373dcae07fb22b818b0e5f598c6a17440; editorial review pending	imf lang::en chapter::031 module::031-01 review::pending
IMF-031-01-0007-en	From which conditions must aphasia be distinguished, and why does this matter?	From dysarthria, deafness, low arousal and language unfamiliarity, because each can mimic a language disorder without the lesion that aphasia implies.	Integrated Medical Foundations; chapter 31, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: e7b0f0365ca2cdb2ed426aa52806d8d373dcae07fb22b818b0e5f598c6a17440; editorial review pending	imf lang::en chapter::031 module::031-01 review::pending
IMF-031-01-0008-en	Why is decision-making capacity assessed for the specific decision rather than inferred from a diagnosis or screening score?	Scores are influenced by education, language, culture, sensory loss, distress, fatigue and disability, and neither a score nor a diagnosis shows whether the person can make this particular decision.	Integrated Medical Foundations; chapter 31, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: e7b0f0365ca2cdb2ed426aa52806d8d373dcae07fb22b818b0e5f598c6a17440; editorial review pending	imf lang::en chapter::031 module::031-01 review::pending
IMF-031-01-0009-en	What does a relative afferent pupillary defect indicate, and why is papilloedema an imperfect sign of raised pressure?	It indicates asymmetric retinal or optic-nerve dysfunction; papilloedema suggests raised pressure but is neither immediate nor universal, so its absence does not exclude it.	Integrated Medical Foundations; chapter 31, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: e7b0f0365ca2cdb2ed426aa52806d8d373dcae07fb22b818b0e5f598c6a17440; editorial review pending	imf lang::en chapter::031 module::031-01 review::pending
IMF-031-01-0010-en	How does forehead involvement distinguish upper from lower motor-neuron facial weakness?	Upper motor-neuron lesions usually spare the forehead, whereas lower motor-neuron lesions affect the whole ipsilateral face.	Integrated Medical Foundations; chapter 31, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: e7b0f0365ca2cdb2ed426aa52806d8d373dcae07fb22b818b0e5f598c6a17440; editorial review pending	imf lang::en chapter::031 module::031-01 review::pending
IMF-031-01-0011-en	Why does examination of palate, voice, cough and swallowing carry safety significance beyond localisation?	Lower cranial dysfunction can threaten the airway and nutrition, so poor secretion control or unsafe swallowing is a direct risk, not only a localising clue.	Integrated Medical Foundations; chapter 31, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: e7b0f0365ca2cdb2ed426aa52806d8d373dcae07fb22b818b0e5f598c6a17440; editorial review pending	imf lang::en chapter::031 module::031-01 review::pending
IMF-031-01-0012-en	How do spasticity, rigidity and paratonia differ when a relaxed joint is moved at different speeds?	Spasticity is velocity-dependent, rigidity is more uniform, and paratonia varies with the patient's cooperation or with frontal dysfunction.	Integrated Medical Foundations; chapter 31, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: e7b0f0365ca2cdb2ed426aa52806d8d373dcae07fb22b818b0e5f598c6a17440; editorial review pending	imf lang::en chapter::031 module::031-01 review::pending
IMF-031-01-0013-en	Which muscle groups are preferentially weak in pyramidal weakness, and how does this differ from root or nerve lesions?	Pyramidal weakness often affects upper-limb extensors and lower-limb flexors more than their opposites, whereas root and nerve lesions follow myotomal or named-nerve patterns.	Integrated Medical Foundations; chapter 31, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: e7b0f0365ca2cdb2ed426aa52806d8d373dcae07fb22b818b0e5f598c6a17440; editorial review pending	imf lang::en chapter::031 module::031-01 review::pending
IMF-031-01-0014-en	Which reflex findings support upper motor-neuron dysfunction, and why must reduced reflexes be interpreted cautiously?	Hyperreflexia, clonus and extensor plantar responses support it; reduced reflexes suggest lower motor-neuron, nerve or root disease or acute spinal shock but can be normal variants.	Integrated Medical Foundations; chapter 31, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: e7b0f0365ca2cdb2ed426aa52806d8d373dcae07fb22b818b0e5f598c6a17440; editorial review pending	imf lang::en chapter::031 module::031-01 review::pending
IMF-031-01-0015-en	Why are cortical sensory tests such as graphesthesia and stereognosis uninterpretable in some patients?	They require intact primary sensation and attention, so a deficit in either produces failure that does not reflect cortical sensory dysfunction.	Integrated Medical Foundations; chapter 31, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: e7b0f0365ca2cdb2ed426aa52806d8d373dcae07fb22b818b0e5f598c6a17440; editorial review pending	imf lang::en chapter::031 module::031-01 review::pending
IMF-031-01-0016-en	What do a sensory level, saddle loss and a stocking distribution each suggest?	A sensory level suggests spinal cord disease, saddle loss suggests cauda equina or conus involvement, and a stocking distribution suggests polyneuropathy.	Integrated Medical Foundations; chapter 31, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: e7b0f0365ca2cdb2ed426aa52806d8d373dcae07fb22b818b0e5f598c6a17440; editorial review pending	imf lang::en chapter::031 module::031-01 review::pending
IMF-031-01-0017-en	What does falling only when the eyes are closed on Romberg testing indicate, and why is it not a cerebellar test?	Removing vision exposes impaired proprioceptive or vestibular compensation; the test assesses maintaining stance without visual input, not cerebellar function in general.	Integrated Medical Foundations; chapter 31, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: e7b0f0365ca2cdb2ed426aa52806d8d373dcae07fb22b818b0e5f598c6a17440; editorial review pending	imf lang::en chapter::031 module::031-01 review::pending
IMF-031-01-0018-en	How do brainstem and cerebellar lesions differ in their pattern of signs?	Brainstem lesions often combine cranial-nerve signs with contralateral body findings, whereas cerebellar lesions produce ipsilateral coordination deficits, eye signs, dysarthria and gait disturbance without primary weakness.	Integrated Medical Foundations; chapter 31, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: e7b0f0365ca2cdb2ed426aa52806d8d373dcae07fb22b818b0e5f598c6a17440; editorial review pending	imf lang::en chapter::031 module::031-01 review::pending
IMF-031-01-0019-en	How do the motor signs of a spinal-cord lesion differ at its level and below it?	It produces segmental lower motor-neuron findings at the lesion and bilateral upper motor-neuron findings below it, possibly with sphincter dysfunction.	Integrated Medical Foundations; chapter 31, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: e7b0f0365ca2cdb2ed426aa52806d8d373dcae07fb22b818b0e5f598c6a17440; editorial review pending	imf lang::en chapter::031 module::031-01 review::pending
IMF-031-01-0020-en	What combination of deficits can hemicord injury produce below the lesion?	Ipsilateral motor and proprioceptive loss combined with contralateral loss of pain and temperature below the lesion.	Integrated Medical Foundations; chapter 31, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: e7b0f0365ca2cdb2ed426aa52806d8d373dcae07fb22b818b0e5f598c6a17440; editorial review pending	imf lang::en chapter::031 module::031-01 review::pending
IMF-031-01-0021-en	How are neuromuscular-junction disease and myopathy distinguished from each other and from polyneuropathy?	Junction disease causes fatigable motor dysfunction and myopathy proximal weakness with reflexes often preserved until late, both without sensory loss, whereas polyneuropathy is usually length-dependent and symmetric.	Integrated Medical Foundations; chapter 31, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: e7b0f0365ca2cdb2ed426aa52806d8d373dcae07fb22b818b0e5f598c6a17440; editorial review pending	imf lang::en chapter::031 module::031-01 review::pending
IMF-031-01-0022-en	What does non-contrast computed tomography do well, and when is magnetic resonance preferred?	Computed tomography rapidly detects blood, mass effect, hydrocephalus and fractures; magnetic resonance gives superior contrast for infarction, demyelination, tumour, infection, posterior fossa, cord, nerve and muscle.	Integrated Medical Foundations; chapter 31, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: e7b0f0365ca2cdb2ed426aa52806d8d373dcae07fb22b818b0e5f598c6a17440; editorial review pending	imf lang::en chapter::031 module::031-01 review::pending
IMF-031-01-0023-en	When should imaging precede lumbar puncture, and what must not be delayed while it is arranged?	When focal mass effect, obstructive hydrocephalus, markedly reduced consciousness or other herniation risk is suspected; essential antimicrobial therapy must not be delayed.	Integrated Medical Foundations; chapter 31, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: e7b0f0365ca2cdb2ed426aa52806d8d373dcae07fb22b818b0e5f598c6a17440; editorial review pending	imf lang::en chapter::031 module::031-01 review::pending
IMF-031-01-0024-en	Why is a normal short electroencephalogram insufficient to exclude epilepsy?	It records cortical electrical activity only during the recording, so a normal short sample does not exclude epilepsy.	Integrated Medical Foundations; chapter 31, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: e7b0f0365ca2cdb2ed426aa52806d8d373dcae07fb22b818b0e5f598c6a17440; editorial review pending	imf lang::en chapter::031 module::031-01 review::pending