Neuroimaging: eye of the tiger sign: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Neuroimaging: eye of the tiger sign

Sample item

A child has progressive dystonia, dysarthria and pigmentary retinopathy. T2 MRI shows bilateral globus pallidus hypointensity with a central region of hyperintensity. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Pantothenate kinase-associated neurodegeneration

In PKAN, iron deposition darkens the globus pallidus while central gliosis and oedema stay bright, giving the eye of the tiger sign. It is the classic imaging marker of this neurodegeneration with brain iron accumulation.

Option by option

  • A. Huntington disease

    Huntington disease shows caudate atrophy.

  • B. Tuberous sclerosis

    Tuberous sclerosis shows tubers and subependymal nodules.

  • C. Leigh syndrome

    Leigh syndrome shows symmetric basal ganglia and brainstem lesions without iron hypointensity.

  • D. Pantothenate kinase-associated neurodegeneration (correct)

    Correct. Pallidal iron with a central bright spot is the eye of the tiger.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is D, Pantothenate kinase-associated neurodegeneration. In PKAN, iron deposition darkens the globus pallidus while central gliosis and oedema stay bright, giving the eye of the tiger sign.

Why is "Huntington disease" not the answer?

Huntington disease shows caudate atrophy.

Why is "Tuberous sclerosis" not the answer?

Tuberous sclerosis shows tubers and subependymal nodules.

Why is "Leigh syndrome" not the answer?

Leigh syndrome shows symmetric basal ganglia and brainstem lesions without iron hypointensity.

What concept does this question test?

It tests Neuroimaging: eye of the tiger sign in Radiology. It is the classic imaging marker of this neurodegeneration with brain iron accumulation.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neuroimaging: eye of the tiger sign?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.