100+ Free ABPN Neurology Practice Questions

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Question 1

Score: 0/0

A 68-year-old man presents with acute right hemiparesis and aphasia 2 hours after symptom onset. CT shows no hemorrhage and ASPECTS score is 8. BP is 172/94, platelets 240K, INR 1.1. What is the best next step?

Lower BP to below 140/90 before any therapy

Administer IV alteplase 0.9 mg/kg (max 90 mg)

Start aspirin 325 mg and observe

Obtain MRI before any treatment decision

to track

2026 Statistics

Key Facts: ABPN Neurology Exam

~300

Total MCQ Items

ABPN Neurology Primary Certification Examination

~8 hr

Total Exam Time

1-day computer-based test including breaks

~15%

Stroke Weight

Largest domain on 2026 ABPN Neurology content outline

$2,050

2026 Exam Fee

ABPN initial certification

4 yr

Required Training

1 PGY-1 + 3 years neurology (ACGME)

Pearson VUE

Test Delivery

Computer-based testing at authorized centers

The ABPN Neurology Primary Certification Exam is a 1-day computer-based test administered at Pearson VUE containing ~300 single-best-answer MCQs over ~8 hours. The 2026 content outline emphasizes stroke/cerebrovascular (~15%), movement disorders (~10%), neuromuscular (~10%), CNS infections and neuro-oncology (~10%), epilepsy (~8%), headache (~8%), demyelinating/neuroinflammatory (~8%), peripheral nerve and neuro-ophthalmology (~8%), autonomic/sleep/pediatric (~8%), dementia/cognitive (~7%), and spinal cord/neurocritical care/biostatistics (~8%). Initial certification fee is ~$2,050; requires ACGME-accredited adult neurology residency.

Sample ABPN Neurology Practice Questions

Try these sample questions to test your ABPN Neurology exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 68-year-old man presents with acute right hemiparesis and aphasia 2 hours after symptom onset. CT shows no hemorrhage and ASPECTS score is 8. BP is 172/94, platelets 240K, INR 1.1. What is the best next step?

A.Lower BP to below 140/90 before any therapy

B.Administer IV alteplase 0.9 mg/kg (max 90 mg)

C.Start aspirin 325 mg and observe

D.Obtain MRI before any treatment decision

Explanation: He is within 4.5-hour alteplase window with no exclusions (BP <185/110, platelets >100K, INR <1.7, no hemorrhage on CT). Standard dose is 0.9 mg/kg (max 90 mg): 10% bolus over 1 min and remainder over 60 min. Time is brain — do not delay for MRI. Tenecteplase 0.25 mg/kg bolus is a reasonable alternative per AHA 2019 update.

2A 74-year-old woman with atrial fibrillation presents 8 hours after last known well with a left M1 MCA occlusion on CTA. CT perfusion shows a small core with large salvageable penumbra (mismatch ratio >1.8). ASPECTS is 7. What is the best intervention?

A.Medical management with aspirin only

B.IV alteplase alone — she is beyond the 4.5-hour window

C.Endovascular thrombectomy based on DAWN/DEFUSE 3 criteria

D.Hemicraniectomy

Explanation: DAWN (6-24 h) and DEFUSE 3 (6-16 h) established endovascular thrombectomy for LVO with favorable imaging (clinical-core or perfusion-core mismatch). She has an M1 LVO, favorable ASPECTS, and mismatch — thrombectomy is indicated up to 24 hours. IV tPA is beyond window and isolated medical management is inferior for LVO.

3A 62-year-old man with hypertension has sudden-onset right hemiparesis. CT shows a 30 mL left basal ganglia hemorrhage. BP is 195/105. Platelets and INR are normal. What is the appropriate acute BP target?

A.Maintain systolic BP 180-200 to preserve perfusion

B.Lower systolic BP to <140 mmHg (INTERACT-2)

C.Lower systolic BP rapidly to <100 mmHg

D.Do not treat unless BP >220/120

Explanation: Per INTERACT-2 and AHA guidelines, for acute ICH with systolic BP 150-220, rapid lowering to <140 mmHg systolic is safe and reduces hematoma expansion. Agents include IV nicardipine, clevidipine, or labetalol. Reverse anticoagulants (PCC for warfarin, idarucizumab for dabigatran, andexanet alfa for Xa inhibitors).

4A 45-year-old woman presents with sudden 'worst headache of life' and brief loss of consciousness. CT shows blood in the basal cisterns and Sylvian fissures. CTA reveals a 6 mm anterior communicating artery aneurysm. After coiling, which medication should be started to reduce delayed cerebral ischemia?

A.IV nicardipine continuous infusion

B.IV heparin infusion

C.Nimodipine 60 mg orally every 4 hours for 21 days

D.Mannitol 1 g/kg

Explanation: Aneurysmal SAH causes vasospasm peaking days 4-14. Oral nimodipine 60 mg every 4 hours for 21 days improves outcomes (does not prevent angiographic vasospasm but reduces delayed cerebral ischemia). If hypotension, reduce to 30 mg q2h. Modern management is euvolemia and induced hypertension (not classic 'triple-H'). EVD if hydrocephalus develops.

5Which TOAST subtype is most consistent with a 72-year-old with AF, embolic appearing cortical-subcortical MCA territory infarct, and no significant carotid disease?

A.Small-vessel (lacunar)

B.Large-artery atherosclerosis

C.Cardioembolic

D.Cryptogenic

Explanation: TOAST classifies ischemic stroke into large-artery atherosclerosis, cardioembolic (AF, LV thrombus, recent MI, endocarditis, mechanical valves), small-vessel lacunar (<1.5 cm in deep territory), other determined etiology (dissection, vasculitis, hypercoagulable), and cryptogenic. AF with cortical/subcortical embolic pattern = cardioembolic.

6A 67-year-old non-valvular AF patient with CHA2DS2-VASc score of 4 requires long-term anticoagulation. Which is the preferred first-line agent?

A.A direct oral anticoagulant (apixaban, rivaroxaban, dabigatran, or edoxaban)

B.Warfarin with INR target 2-3

C.Aspirin 81 mg daily

D.Clopidogrel 75 mg daily

Explanation: Current guidelines recommend DOACs as first-line over warfarin for non-valvular AF given lower intracranial hemorrhage risk and equivalent/superior stroke prevention. Warfarin remains preferred only for mechanical heart valves and moderate-severe mitral stenosis. Aspirin monotherapy is inadequate for stroke prevention in AF.

7A 70-year-old man with a recent right hemispheric TIA is found to have 80% stenosis of the right internal carotid artery. What is the best intervention?

A.Bypass surgery

B.Medical therapy with aspirin alone

C.Carotid artery stenting regardless of age

D.Carotid endarterectomy within 2 weeks

Explanation: NASCET showed clear benefit of CEA for symptomatic carotid stenosis ≥70%. Ideally performed within 2 weeks of the index event. For symptomatic 50-69% stenosis, CEA has modest benefit and is selected based on patient factors. For asymptomatic stenosis, benefit is smaller. Stenting is an alternative particularly in younger patients or those with surgically inaccessible lesions.

8A 42-year-old with cryptogenic ischemic stroke is found to have a patent foramen ovale with right-to-left shunt on bubble study. After 6 weeks of anticoagulation, what long-term strategy is supported by recent trials?

A.Indefinite systemic anticoagulation

B.Percutaneous PFO closure for cryptogenic stroke in patients <60 years

C.Aspirin only, PFO closure not indicated

D.Surgical PFO closure

Explanation: Per CLOSE, RESPECT long-term follow-up, and REDUCE trials, percutaneous PFO closure plus antiplatelet therapy reduces recurrent stroke compared with medical therapy alone in patients <60 years with cryptogenic stroke and PFO (especially with large shunt or atrial septal aneurysm). AAN 2020 guideline supports closure in selected patients.

9A 38-year-old woman on oral contraceptives with headache for 1 week develops seizure and left hemiparesis. MRI/MRV shows a clot in the superior sagittal sinus. What is the initial treatment?

A.Therapeutic anticoagulation with IV heparin or LMWH

B.IV tPA for stroke

C.Corticosteroids

D.Craniotomy for clot evacuation

Explanation: Cerebral venous sinus thrombosis is treated with therapeutic anticoagulation (heparin or LMWH) even if there is associated venous hemorrhage. Risk factors include OCPs, pregnancy/puerperium, thrombophilia, dehydration, malignancy. Endovascular intervention is reserved for deteriorating patients. Long-term anticoagulation for 3-6 months.

10A 65-year-old has a brief right arm weakness and aphasia resolving in 45 minutes. What ABCD2 component gives the highest point value?

A.Duration 10-59 minutes (1 point)

B.Age ≥60 (1 point)

C.BP ≥140/90 (1 point)

D.Unilateral weakness (2 points)

Explanation: ABCD2: Age ≥60 = 1; BP ≥140/90 = 1; Clinical features — unilateral weakness = 2, speech disturbance without weakness = 1; Duration — ≥60 min = 2, 10-59 min = 1; Diabetes = 1. Higher scores predict higher 2-day stroke risk and guide hospitalization decisions. Modern practice favors urgent imaging and rapid workup regardless.

About the ABPN Neurology Exam

The ABPN Neurology Primary Certification Examination is the board-certifying exam administered by the American Board of Psychiatry and Neurology for adult neurologists. It is a 1-day computer-based test containing approximately 300 single-best-answer MCQs spanning stroke and cerebrovascular disease (TOAST, tPA, endovascular thrombectomy, ICH, SAH), headache (migraine, cluster, TACs, CGRP therapies), epilepsy (ILAE 2017, AED selection, status epilepticus, ESETT), movement disorders (Parkinson, atypical parkinsonism, essential tremor, Huntington, tardive dyskinesia), multiple sclerosis and neuroinflammatory disease (McDonald 2017, DMTs, NMOSD, autoimmune encephalitis), neuromuscular disorders (ALS, MG, LEMS, GBS, CIDP, CMT, NCS/EMG), dementia (Alzheimer, DLB, FTD, CJD, NPH), CNS infections, neuro-oncology (WHO 2021), neuro-ophthalmology, autonomic, sleep, pediatric neurology, spinal cord disease, neurocritical care, and biostatistics/ethics. Requires completion of an ACGME-accredited adult neurology residency (1 PGY-1 year + 3 years of neurology).

Questions

300 scored questions

Time Limit

1-day CBT (~8 hours including breaks)

Passing Score

Criterion-referenced scaled score set by ABPN

Exam Fee

~$2,050 initial certification fee (ABPN 2026) (American Board of Psychiatry and Neurology (ABPN) / Pearson VUE)

ABPN Neurology Exam Content Outline

~15%

Stroke & Cerebrovascular Disease

Ischemic vs hemorrhagic stroke, TOAST classification (cardioembolic, large-artery, small-vessel lacunar, other, cryptogenic), ABCD2 TIA score, NIHSS. IV alteplase 0-4.5h with exclusions (BP>185/110, platelets <100K, INR>1.7, recent ICH/surgery/GI bleed); tenecteplase non-inferior (AHA 2019 update). Endovascular thrombectomy for LVO up to 24h (DAWN, DEFUSE 3 — perfusion mismatch, ASPECTS). Carotid endarterectomy ≥70% symptomatic (NASCET) or 50-69% select. AF anticoagulation (CHA2DS2-VASc, DOAC first-line except mechanical valve/moderate-severe MS). PFO closure <60y cryptogenic. ICH (INTERACT-2 BP<140, PCC/idarucizumab/andexanet reversal). SAH (nimodipine 60 mg q4h, vasospasm day 4-14, euvolemia + induced HTN, EVD).

~10%

Movement Disorders

Parkinson disease — cardinal features (bradykinesia + rest tremor/rigidity/postural); levodopa-carbidopa first-line (motor benefit), MAO-B inhibitors (selegiline, rasagiline), dopamine agonists (pramipexole, ropinirole — impulse control disorder risk), COMT (entacapone, opicapone), amantadine for dyskinesia, DBS (STN or GPi), foslevodopa continuous SC. Atypical parkinsonism — MSA (autonomic/cerebellar), PSP (vertical supranuclear gaze palsy, early falls), CBD (alien limb), DLB (fluctuations, visual hallucinations, RBD, antipsychotic sensitivity). Essential tremor (propranolol, primidone). Huntington (CAG >40, tetrabenazine/deutetrabenazine). Tourette. Tardive dyskinesia (VMAT2 — valbenazine, deutetrabenazine). RLS (check ferritin).

~10%

Neuromuscular Disorders

ALS (UMN+LMN, riluzole, edaravone, tofersen for SOD1 mutations). Myasthenia gravis (AChR-Ab, MuSK-Ab, decremental RNS on 2-3 Hz; pyridostigmine, steroids/AZA/MMF, rituximab, efgartigimod/zilucoplan, thymectomy especially if thymoma; IVIG/PLEX for myasthenic crisis). LEMS (anti-VGCC, paraneoplastic SCLC, post-exercise facilitation/incremental RNS; 3,4-diaminopyridine). GBS/AIDP (ascending paralysis, albuminocytologic dissociation on CSF, IVIG or PLEX — steroids NOT effective). Miller Fisher variant (anti-GQ1b; ataxia/ophthalmoplegia/areflexia). CIDP (IVIG/PLEX/steroids). CMT1A (PMP22 duplication). Diabetic polyneuropathy (duloxetine, pregabalin, gabapentin). Dermatomyositis, inclusion body myositis.

~10%

CNS Infections & Neuro-Oncology

Bacterial meningitis — empiric ceftriaxone + vancomycin; ADD ampicillin if >50y, immunocompromised, or alcoholism (Listeria coverage). Dexamethasone before or with first antibiotic dose for S. pneumoniae. HSV encephalitis (temporal lobe FLAIR hyperintensity, CSF PCR, IV acyclovir 10 mg/kg q8h for 14-21 days). Neurosyphilis (CSF VDRL — specific; IV penicillin G). Lyme neuroborreliosis, HIV neuro (PML — JC virus; toxoplasmosis; cryptococcus; CMV; primary CNS lymphoma EBV+). Neuro-oncology per WHO 2021 — glioma with IDH mutation better prognosis; GBM (IDH-wt) Stupp protocol (TMZ + RT); 1p/19q co-deletion defines oligodendroglioma; MGMT methylation predicts TMZ response. Brain metastases WBRT vs stereotactic radiosurgery. Paraneoplastic (anti-Hu/Yo/Ma/Ri).

~8%

Epilepsy & Seizure Disorders

ILAE 2017 classification — focal onset (aware vs impaired awareness; motor vs non-motor), generalized onset (tonic-clonic, absence, myoclonic, atonic, tonic, clonic), unknown onset. Status epilepticus — IV lorazepam 0.1 mg/kg (max 4 mg) → fosphenytoin/levetiracetam/valproate per ESETT trial → third-line midazolam/propofol/phenobarbital/ketamine infusion; convulsive if >5 minutes; check NCSE with EEG in persistent altered mental status. AED selection — focal (lamotrigine, levetiracetam, oxcarbazepine, lacosamide); generalized (valproate, lamotrigine, levetiracetam); absence (ethosuximide first-line). AVOID carbamazepine/phenytoin/oxcarbazepine in generalized (can worsen absence/myoclonic). Pregnancy (lamotrigine/levetiracetam safest; AVOID valproate — spina bifida/IQ decline). SUDEP counseling. Epilepsy surgery, LITT, RNS, VNS, ketogenic diet.

~8%

Headache Disorders

Migraine with/without aura; chronic migraine ≥15 days/month; medication overuse headache. Cluster headache — unilateral periorbital with cranial autonomic features (miosis/ptosis/lacrimation/rhinorrhea); acute: 100% O2 12-15 L/min via non-rebreather, subcutaneous sumatriptan; preventive: verapamil. Tension-type. Trigeminal autonomic cephalalgias — paroxysmal hemicrania (ABSOLUTELY indomethacin-responsive), SUNCT/SUNA, hemicrania continua (indomethacin-responsive). Preventives — topiramate, amitriptyline, propranolol, candesartan; CGRP monoclonal antibodies (erenumab, fremanezumab, galcanezumab, eptinezumab); gepants (rimegepant, atogepant); onabotulinumtoxinA 155U PREEMPT protocol for chronic migraine. Abortives — triptans, gepants, ditans (lasmiditan), DHE. Post-LP headache (epidural blood patch).

~8%

Demyelinating & Neuroinflammatory

Multiple sclerosis — subtypes (RRMS, SPMS, PPMS); McDonald 2017 criteria require dissemination in space AND time (clinical + MRI). DMTs — platform (interferons, glatiramer); oral (teriflunomide, dimethyl fumarate, fingolimod — first-dose cardiac monitoring, siponimod, ozanimod, cladribine); infusion (natalizumab — stratify JC virus antibody for PML risk, ocrelizumab B-cell depletion, ofatumumab SC). NMOSD (anti-aquaporin-4 IgG; longitudinally extensive transverse myelitis, severe optic neuritis, area postrema syndrome; eculizumab, inebilizumab, satralizumab). MOG-AD. Autoimmune encephalitis — anti-NMDA (young women + ovarian teratoma; psychiatric prodrome → seizures → movement → autonomic); anti-LGI1 (faciobrachial dystonic seizures, hyponatremia); anti-CASPR2 (Morvan), anti-GABA-B.

~8%

Peripheral Nerve, Radiculopathy & Neuro-Ophthalmology

Cervical radiculopathy (C6, C7 most common — Spurling maneuver); lumbar radiculopathy (L5 — foot drop, dorsiflexion weakness; S1 — plantarflexion, ankle reflex loss); carpal tunnel (median nerve — thenar atrophy, Phalen/Tinel, NCS); ulnar neuropathy at the elbow (Froment sign, cubital tunnel); peroneal neuropathy at fibular head (foot drop, spares inversion); sciatica; cauda equina syndrome (saddle anesthesia, bladder/bowel, bilateral leg — EMERGENT MRI and surgical decompression). Optic neuritis (steroids accelerate recovery but do not change long-term visual acuity). Horner syndrome (ptosis/miosis/anhidrosis — cocaine or apraclonidine pharmacologic testing; localize 1st/2nd/3rd-order). CN III (down-and-out + dilated pupil compressive PCOM aneurysm; pupil-sparing microvascular), IV, VI palsies.

~7%

Dementia & Cognitive Neurology

Alzheimer disease (hippocampal atrophy, amyloid-beta plaques + tau tangles; CSF biomarkers — low Aβ42, elevated total and phospho-tau; amyloid PET; cholinesterase inhibitors — donepezil, rivastigmine, galantamine; memantine for moderate-severe; anti-amyloid monoclonal antibodies lecanemab, donanemab with ARIA-E/H MRI monitoring). Vascular dementia. Dementia with Lewy bodies (fluctuating cognition, visual hallucinations, RBD, parkinsonism within 1 year; AVOID typical antipsychotics — neuroleptic sensitivity). Frontotemporal dementia (behavioral variant with disinhibition/apathy; primary progressive aphasia). Creutzfeldt-Jakob disease (rapidly progressive dementia + myoclonus; 14-3-3 and RT-QuIC; cortical ribboning and pulvinar sign on DWI MRI). Normal pressure hydrocephalus (gait/cognition/urinary triad; shunt-responsive).

~8%

Autonomic, Sleep & Pediatric Neurology

Orthostatic hypotension — neurogenic (pure autonomic failure, MSA, PD, diabetic autonomic) vs non-neurogenic (volume depletion, meds); treat with adequate hydration/salt, compression, fludrocortisone, midodrine, droxidopa. POTS. Narcolepsy type 1 (hypocretin/orexin deficiency, cataplexy, short sleep-onset REM periods on MSLT; modafinil/armodafinil, pitolisant, sodium oxybate, solriamfetol). REM sleep behavior disorder (alpha-synuclein prodrome — PD/DLB/MSA; melatonin, clonazepam). RLS (ferritin target >75; dopamine agonists, gabapentin enacarbil, iron). Pediatric — infantile spasms (West syndrome, hypsarrhythmia on EEG; ACTH, vigabatrin — especially in tuberous sclerosis); Dravet syndrome (SCN1A, febrile prolonged seizures in infancy). Cerebral palsy. Neurometabolic.

~8%

Spinal Cord, Neurocritical Care & Biostatistics

Cervical spondylotic myelopathy (UMN signs in legs, hand clumsiness). B12 deficiency — subacute combined degeneration (dorsal columns + corticospinal + peripheral; macrocytic anemia, elevated MMA/homocysteine). Copper deficiency myelopathy (mimics B12; zinc excess, bariatric surgery). Syringomyelia (cape-like pain/temp loss). Transverse myelitis (acute/subacute, sensory level, bladder; consider MS, NMOSD, MOG, infectious). Neurocritical care — elevated ICP (head elevation 30°, hyperosmolar therapy mannitol/3% saline, decompression). Brain death determination — coma with known cause, absent brainstem reflexes (pupils, corneal, OCR/VOR, gag/cough), apnea test (PaCO2 >60 or rise ≥20 without respiratory effort); ancillary EEG, nuclear perfusion, TCD if apnea cannot be performed. Biostatistics — sensitivity/specificity, PPV/NPV, NNT, NNH, likelihood ratios. Research ethics and informed consent.

How to Pass the ABPN Neurology Exam

What You Need to Know

Passing score: Criterion-referenced scaled score set by ABPN
Exam length: 300 questions
Time limit: 1-day CBT (~8 hours including breaks)
Exam fee: ~$2,050 initial certification fee (ABPN 2026)

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

ABPN Neurology Study Tips from Top Performers

1Acute ischemic stroke: IV alteplase 0.9 mg/kg (max 90 mg; 10% bolus, remainder over 60 min) within 4.5 hours of last known well. Tenecteplase single 0.25 mg/kg bolus is a reasonable alternative (AHA 2019 update). Absolute exclusions include active intracranial hemorrhage, recent ischemic stroke <3 months, platelets <100K, INR >1.7, LMWH within 24h, BP >185/110 despite treatment, and recent major surgery/GI bleed. Endovascular thrombectomy for LVO (ICA, proximal MCA M1) up to 24 hours with favorable imaging per DAWN and DEFUSE 3 (perfusion/core mismatch, ASPECTS ≥6).

2ILAE 2017 classification: start with onset — focal (aware vs impaired awareness, then motor vs non-motor), generalized (tonic-clonic, absence, myoclonic, atonic, tonic, clonic, myoclonic-tonic-clonic, myoclonic-atonic, epileptic spasms), or unknown onset. Key AED pitfall: carbamazepine, phenytoin, oxcarbazepine, gabapentin, and tiagabine can WORSEN absence and myoclonic seizures. Ethosuximide is first-line for childhood absence only (not tonic-clonic). For women of childbearing age: lamotrigine and levetiracetam are safest; AVOID valproate (spina bifida, reduced IQ) and topiramate (cleft palate).

3Status epilepticus (ESETT): 0-5 min stabilize airway/IV; 5-20 min IV benzodiazepine — lorazepam 0.1 mg/kg (max 4 mg per dose), diazepam, or IM midazolam if no IV; 20-40 min second-line per ESETT — IV fosphenytoin, levetiracetam, or valproate (all roughly equivalent); 40-60 min third-line — midazolam, propofol, phenobarbital, or ketamine continuous infusion with cEEG. Remember non-convulsive status in persistent altered mental status after convulsions stop — check EEG.

4MS McDonald 2017 criteria: dissemination in SPACE requires ≥1 T2 lesion in ≥2 of 4 characteristic CNS areas (periventricular, cortical/juxtacortical, infratentorial, spinal cord). Dissemination in TIME requires simultaneous enhancing + non-enhancing lesions on any single MRI, OR a new T2/enhancing lesion on follow-up MRI, OR CSF-specific oligoclonal bands (now allowed as DIT substitute). For natalizumab (anti-VLA-4), check JC virus antibody index — if positive and index >1.5 with >2 years of therapy, PML risk rises sharply; consider switching or extended-interval dosing.

5Brain death determination requires: (1) known irreversible catastrophic brain injury; (2) exclusion of confounders (drugs, hypothermia <36°C, severe metabolic/endocrine, neuromuscular blockade); (3) coma; (4) absent brainstem reflexes — pupils (fixed midposition), corneal, oculocephalic and vestibulo-ocular (cold calorics), gag, cough; (5) apnea test — preoxygenate to PaO2 >200, disconnect ventilator, confirm PaCO2 rise to >60 mmHg or ≥20 mmHg above baseline without respiratory effort. Ancillary tests (EEG, nuclear cerebral perfusion, TCD) are used when clinical exam or apnea test cannot be completed.

Frequently Asked Questions

What is the ABPN Neurology Primary Certification Examination?

The ABPN Neurology Primary Certification Examination is the board-certifying exam administered by the American Board of Psychiatry and Neurology (ABPN) for adult neurologists. It is a 1-day computer-based multiple-choice exam delivered at Pearson VUE test centers. The exam assesses comprehensive knowledge across adult neurology including stroke and cerebrovascular disease, headache, epilepsy, movement disorders, multiple sclerosis and neuroinflammatory disorders, neuromuscular disease, dementia and cognitive neurology, CNS infections, neuro-oncology, peripheral nerve and radiculopathy, neuro-ophthalmology, autonomic and sleep disorders, pediatric neurology essentials, spinal cord disease, neurocritical care, and biostatistics/ethics. Successful candidates receive initial certification valid within the ABPN Continuing Certification (MOC) 10-year cycle.

Who is eligible to take the ABPN Neurology exam?

Candidates must have completed an ACGME-accredited adult Neurology residency program totaling 4 years of postgraduate training: 1 PGY-1 year (typically internal medicine, transitional, or ABPN-approved equivalent) plus 3 years of dedicated neurology residency (PGY-2 through PGY-4). Candidates must hold a valid unrestricted medical license and receive program director attestation of satisfactory completion. Applications are submitted through the ABPN website within the designated credentialing window.

What is the format of the ABPN Neurology exam?

The exam is a 1-day computer-based test delivered at Pearson VUE centers, consisting of approximately 300 single-best-answer multiple-choice questions over roughly 8 hours including scheduled breaks. Questions frequently include clinical vignettes, MRI and CT imaging, EEG tracings, NCS/EMG traces, and photographs. Content is distributed across the ABPN Neurology content outline, with heaviest weighting on stroke/cerebrovascular, movement disorders, neuromuscular disorders, infections/neuro-oncology, epilepsy, headache, and demyelinating disease.

How much does the 2026 ABPN Neurology exam cost?

The 2026 ABPN Neurology initial certification fee is approximately $2,050. ABPN refund and cancellation schedules apply as the exam date approaches. Continuing Certification (MOC) operates on a 10-year cycle and involves Article-Based CME and annual self-assessment activities, each with associated fees. Retakes within the eligibility window require full re-registration and fee payment.

When is the 2026 exam administered?

The ABPN Neurology Primary Certification Examination is typically offered once per year in a fall testing window (historically October). Credentialing applications open earlier in the year with a submission deadline prior to the testing window. Candidates schedule specific Pearson VUE appointments after credentialing approval. Exact 2026 dates should be confirmed on the ABPN Neurology certification page.

How is the exam scored?

ABPN uses a criterion-referenced scaled scoring system with a passing standard set by subject-matter experts. A candidate's pass/fail outcome depends on performance relative to the fixed cut-score rather than on other test-takers. Score reports include subdomain performance to guide future study. Results are typically released several weeks after the testing window closes.

What are the highest-yield topics?

Highest-yield topics include acute ischemic stroke management (TOAST classification, NIHSS, IV alteplase/tenecteplase 0-4.5h with exclusions, endovascular thrombectomy for LVO up to 24h with DAWN/DEFUSE 3); ICH and SAH management (INTERACT-2 BP<140, nimodipine, vasospasm); ILAE 2017 seizure classification and AED selection (ethosuximide for absence, AVOID carbamazepine/phenytoin in generalized, lamotrigine/levetiracetam for pregnancy); status epilepticus ladder (ESETT); McDonald 2017 MS criteria and DMT safety (JCV/PML stratification for natalizumab); Parkinson pharmacology and DBS; MG pharmacology and crisis management; ALS (riluzole, edaravone, tofersen); autoimmune encephalitis (anti-NMDA, anti-LGI1); HSV encephalitis (IV acyclovir 14-21 days); bacterial meningitis empiric therapy and dexamethasone; and brain death determination.

How should I study for ABPN Neurology?

Use a structured 12-18 month plan during PGY-3 and PGY-4. Map to the ABPN Neurology content outline: lead with high-weight domains (stroke, movement, neuromuscular, infections/oncology), then epilepsy, headache, demyelinating/neuroinflammatory, peripheral/neuro-ophthalmology, dementia/cognitive, autonomic/sleep/pediatric, and spinal cord/neurocritical/biostatistics. Core resources include Continuum: Lifelong Learning in Neurology (AAN), Blueprints Neurology, Bradley's Neurology in Clinical Practice, Adams and Victor's Principles of Neurology, Neurology Self-Assessment (NeuroSAE), and AAN RITE score reports. Drill high-volume MCQs with timed sets and complete 2-3 full-length timed mock exams before the testing window.