100+ Free Facharzt FMH Neurologie Practice Questions

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2026 Statistics

Key Facts: Facharzt FMH Neurologie Exam

SNG / SSN

Exam Body

Swiss Neurological Society

Written + Oral/Practical

Exam Format

SNG Examination Regulations

6 Years

Postgraduate Training

SIWF Weiterbildungsprogramm

240 min

Written Exam Duration

SNG Examination Committee

Lifetime

FMH Title Validity

Swiss Medical Association (FMH)

100

Practice Questions

OpenExamPrep

The Facharzt FMH Neurologie credential certifies specialist neurologists in Switzerland through SIWF and SNG. Examination assessment comprises a 4-hour written English MCQ paper, a structured oral case examination, and a practical clinical exam, covering stroke, epilepsy, neuroimmunology, movement disorders, neuromuscular diseases, dementia, headache, and neuro-infections.

Sample Facharzt FMH Neurologie Practice Questions

Try these sample questions to test your Facharzt FMH Neurologie 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 to the emergency department 1 hour and 45 minutes after the sudden onset of right-sided hemiparesis and global aphasia (NIHSS 16). Non-contrast head CT shows no acute intracranial hemorrhage and an ASPECTS score of 9 (subtle hypoattenuation in the lentiform nucleus). Blood pressure is 172/94 mmHg, blood glucose is 6.2 mmol/L (112 mg/dL), and platelet count is 240,000/mcL. He takes aspirin 100 mg daily for primary prevention. According to European Stroke Organisation (ESO) and Swiss Neurological Society guidelines, what is the most appropriate immediate medical management?

A.Initiate intravenous thrombolysis with alteplase (0.9 mg/kg) or tenecteplase (0.25 mg/kg) immediately while proceeding to CT angiography

B.Withhold intravenous thrombolysis because the patient is taking daily aspirin and administer clopidogrel 300 mg loading dose

C.Administer intravenous labetalol to lower systolic blood pressure below 140 mmHg before considering thrombolysis

D.Defer systemic thrombolysis and perform primary catheter angiography for intra-arterial thrombectomy alone

Explanation: Intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator (alteplase 0.9 mg/kg, max 90 mg) or tenecteplase (0.25 mg/kg, max 25 mg) is indicated for acute ischemic stroke within 4.5 hours of symptom onset in the absence of contraindications. The patient is within the 4.5-hour therapeutic window, blood pressure is below the exclusion threshold of 185/110 mmHg, and prior antiplatelet monotherapy is not a contraindication. Reperfusion therapy must not be delayed while awaiting vascular imaging.

2A 62-year-old woman awakens at 07:00 with severe left-sided hemiparesis and spatial neglect. She was last seen in her normal state of health at 22:30 when going to sleep. She arrives at the stroke center at 08:30. Multimodal brain MRI demonstrates acute diffusion restriction in the right middle cerebral artery (MCA) territory on diffusion-weighted imaging (DWI) without corresponding signal hyperintensity on fluid-attenuated inversion recovery (FLAIR) imaging. CT/MR angiography reveals no large vessel occlusion. Based on the WAKE-UP trial and current ESO guidelines, what is the best management strategy?

A.Withhold intravenous thrombolysis and administer aspirin 300 mg orally, as symptom onset was >4.5 hours ago

B.Administer intravenous thrombolysis with alteplase based on the positive DWI-FLAIR mismatch

C.Initiate therapeutic dose low-molecular-weight heparin (LMWH) for non-large vessel wake-up stroke

D.Perform emergency stereotactic burr-hole craniostomy to relieve impending cerebral edema

Explanation: The landmark WAKE-UP trial demonstrated that in patients with acute ischemic stroke of unknown onset (including wake-up stroke), a DWI-FLAIR mismatch—characterized by acute ischemia visible on diffusion-weighted imaging but not yet visible on FLAIR—identifies patients within 4.5 hours of tissue infarction onset who achieve significantly improved functional outcomes with intravenous alteplase without an excess of symptomatic intracerebral hemorrhage.

3A 74-year-old man presents 14 hours after last being seen well with a severe right middle cerebral artery stroke syndrome (NIHSS 18). CT perfusion and CT angiography reveal an occlusion of the right proximal M1 segment, an ischemic core volume (rCBF <30%) of 18 mL, and a total hypoperfused hypoperfusion volume (Tmax >6.0 s) of 110 mL (mismatch volume 92 mL, mismatch ratio 6.1). His baseline modified Rankin Scale (mRS) score was 0. According to the DAWN and DEFUSE-3 criteria, what is the most appropriate next step?

A.Conservative supportive care on the stroke unit, as the 6-hour therapeutic window for mechanical intervention has elapsed

B.Intravenous thrombolysis with tenecteplase 0.40 mg/kg

C.Immediate endovascular mechanical thrombectomy

D.Urgent superficial temporal artery to middle cerebral artery (STA-MCA) bypass surgery

Explanation: The DAWN and DEFUSE-3 trials established that endovascular mechanical thrombectomy is safe and highly efficacious up to 16–24 hours after symptom onset in selected patients with anterior circulation large vessel occlusion who have a substantial mismatch between clinical severity/perfusion deficit and small ischemic core volume (core <70 mL, mismatch ratio ≥1.8, mismatch volume ≥15 mL).

4A 58-year-old woman presents 10 hours after the acute onset of dysarthria, quadriplegia, bilateral horizontal gaze palsy, and fluctuating consciousness (NIHSS 22, pc-ASPECTS 8). CT angiography demonstrates an acute occlusion of the mid-basilar artery. Advanced perfusion neuroimaging confirms extensive salvageable tissue in the brainstem and cerebellum. Based on recent randomized trials (BAOCHE and ATTENTION), what is the definitive recommended treatment?

A.High-dose intravenous heparin infusion with target aPTT of 70–90 seconds alone

B.Immediate intravenous nimodipine infusion combined with hypervolemic hemodilution therapy

C.Bilateral vertebral artery angioplasty without stent placement or clot retrieval

D.Endovascular mechanical thrombectomy with or without bridging thrombolysis

Explanation: Randomized clinical trials (BAOCHE and ATTENTION) demonstrated that endovascular mechanical thrombectomy significantly improves functional independence (mRS 0–3) and reduces mortality compared with best medical management alone in patients presenting with acute basilar artery occlusion within 12 to 24 hours of symptom onset.

5A 65-year-old man presents 2 hours after the acute onset of a right basal ganglia intracerebral hemorrhage (ICH volume 22 mL, no intraventricular extension). On arrival, his Glasgow Coma Scale (GCS) score is 13, and his initial blood pressure is 205/115 mmHg. He is not receiving any anticoagulant therapy. According to European Stroke Organisation (ESO) and INTERACT-2/ATACH-2 guidelines, what is the target systolic blood pressure (SBP) and recommended management strategy?

A.Smoothly lower systolic blood pressure to a target range of 130–140 mmHg using intravenous titratable agents such as labetalol, urapidil, or nicardipine

B.Maintain systolic blood pressure above 180 mmHg to preserve cerebral perfusion pressure around the hematoma

C.Rapidly reduce systolic blood pressure to below 110 mmHg within the first 30 minutes using sodium nitroprusside

D.Withhold all antihypertensive therapy for the first 48 hours unless systolic blood pressure exceeds 240 mmHg

Explanation: In acute spontaneous intracerebral hemorrhage presenting within 6 hours of onset with elevated blood pressure, current guidelines (ESO/AHA) recommend rapid and smooth blood pressure reduction to a systolic target of 130–140 mmHg (avoiding SBP <120 mmHg) using IV titratable agents (e.g., urapidil, labetalol, nicardipine) to reduce hematoma expansion and improve functional recovery without causing cerebral hypoperfusion.

6A 71-year-old woman taking dabigatran 150 mg twice daily for non-valvular atrial fibrillation is admitted with an acute left lobar intracerebral hemorrhage (ICH). Her last dose of dabigatran was taken 3 hours ago. Her activated partial thromboplastin time (aPTT) and dilute thrombin time (dTT) are markedly prolonged. What is the specific first-line reversal agent of choice?

A.Andexanet alfa 800 mg IV bolus

B.Idarucizumab 5 g IV (administered as two consecutive 2.5 g infusions)

C.Recombinant activated Factor VII (rFVIIa) 90 mcg/kg IV

D.Intravenous Vitamin K 10 mg plus fresh frozen plasma (FFP) 15 mL/kg

Explanation: Idarucizumab is a humanized monoclonal antibody fragment (Fab) that specifically binds dabigatran and its metabolites with 350-fold higher affinity than thrombin, neutralizing its anticoagulant effect within minutes. The standard dosing is 5 g IV administered as two consecutive 2.5 g doses (RE-VERSE AD trial).

7An 80-year-old man taking apixaban 5 mg twice daily presents with acute headache, vomiting, and a right cerebellar hemisphere hematoma with mass effect on the fourth ventricle requiring urgent suboccipital decompressive craniectomy. His last apixaban dose was 4 hours prior to admission. What is the recommended strategy for rapid reversal of Factor Xa inhibition?

A.Protamine sulfate 50 mg slow IV infusion

B.Desmopressin (DDAVP) 0.3 mcg/kg IV plus tranexamic acid 1 g IV

C.Andexanet alfa (or 4-factor Prothrombin Complex Concentrate [4F-PCC] at 50 IU/kg if Andexanet is unavailable)

D.Idarucizumab 5 g IV infusion followed by platelet transfusion

Explanation: For life-threatening bleeding or emergency neurosurgery in patients receiving oral Factor Xa inhibitors (apixaban, rivaroxaban), Andexanet alfa (recombinant modified decoy Factor Xa) is the approved specific reversal agent. If Andexanet alfa is unavailable, guidelines strongly recommend non-activated 4-factor Prothrombin Complex Concentrate (4F-PCC, 25–50 IU/kg) to restore thrombin generation.

8A 52-year-old woman experiences a sudden, catastrophic "thunderclap" headache while exercising. CT scan confirms diffuse subarachnoid hemorrhage (Hunt-Hess grade 2, modified Fisher grade 3). Digital subtraction angiography (DSA) demonstrates a 7 mm anterior communicating artery saccular aneurysm that is successfully secured via endovascular coiling within 18 hours. Which pharmacological agent is proven to improve neurological outcomes and reduce delayed cerebral ischemia (DCI) in aneurysmal subarachnoid hemorrhage?

A.Intravenous magnesium sulfate infusion titrated to serum magnesium 2.5–3.0 mmol/L

B.High-dose systemic corticosteroids (dexamethasone 8 mg every 6 hours)

C.Subcutaneous enoxaparin 1 mg/kg twice daily starting on day 1

D.Oral nimodipine 60 mg every 4 hours for 21 days

Explanation: Enteral nimodipine (60 mg every 4 hours for 21 days) is the only pharmacological agent with robust Class I, Level A evidence showing significant reduction in delayed cerebral ischemia (DCI), cerebral infarction, and poor functional outcome following aneurysmal subarachnoid hemorrhage. Its primary mechanism is neuroprotective and microvascular rather than large-vessel vasodilatory.

9A 29-year-old woman taking combined oral contraceptives presents with a 4-day history of progressive holocranial headache, papilledema, and a focal motor seizure involving her right arm. Brain MRI and MR venography (MRV) demonstrate thrombosis of the superior sagittal and right transverse sinuses with a small right frontal venous hemorrhagic infarction. What is the standard first-line therapy according to European Academy of Neurology (EAN) and ESO guidelines?

A.Therapeutic anticoagulation with weight-adjusted low-molecular-weight heparin (LMWH) or unfractionated heparin, despite the presence of intracranial hemorrhage

B.Immediate surgical decompressive craniectomy and mechanical thrombectomy before any medical therapy

C.Aspirin 300 mg daily plus clopidogrel 75 mg daily, withholding heparin due to intracranial hemorrhage

D.Intravenous mannitol and hypertonic saline alone without anticoagulation until the hemorrhage completely resolves on repeat imaging

Explanation: In cerebral venous sinus thrombosis (CVST), therapeutic anticoagulation (preferably body-weight adjusted subcutaneous LMWH or IV unfractionated heparin) is the primary first-line therapy, even in the presence of venous hemorrhagic infarction. The hemorrhage is caused by venous congestion and outflow obstruction; anticoagulation prevents thrombus propagation, recanalizes venous outflow, and reduces venous hypertension.

10A 38-year-old recreational tennis player presents with acute right-sided neck pain, ipsilateral ptosis, and miosis (painful Horner syndrome), followed 6 hours later by transient left arm weakness. MR angiography reveals an internal carotid artery dissection with an intramural hematoma causing 60% luminal narrowing. Brain MRI shows no acute infarction. Based on the CADISS and TREAT-CAD trials, what is the recommended antithrombotic management?

A.Emergency carotid artery stenting with dual antiplatelet therapy

B.Antithrombotic therapy with either antiplatelet agents (e.g., aspirin 100 mg daily) or anticoagulation for 3 to 6 months

C.High-dose systemic corticosteroid therapy to resolve vessel wall inflammation

D.Intravenous thrombolysis followed by indefinite warfarin anticoagulation with target INR 3.0–4.0

Explanation: Randomized evidence from the CADISS and TREAT-CAD trials demonstrates comparable clinical efficacy between antiplatelet therapy (e.g., aspirin) and anticoagulation for the prevention of recurrent ischemic events in cervical artery dissection. Guidelines recommend antithrombotic treatment for 3 to 6 months followed by repeat vascular imaging to evaluate vessel healing and recanalization.

About the Facharzt FMH Neurologie Exam

The Facharzt FMH für Neurologie (Specialist in Neurology FMH) is the Swiss Federal specialist title granting full independent practice rights in neurology across Switzerland. Governed by the SIWF (Swiss Institute for Postgraduate and Continuous Medical Training) and the SNG (Schweizerische Neurologische Gesellschaft / Swiss Neurological Society), board certification requires passing the national SNG Facharztprüfung Neurologie. The examination is structured into a written Multiple-Choice examination (administered in English) and a structured oral and practical clinical examination (administered in German, French, or English). The curriculum is aligned with European Academy of Neurology (EAN) and European Board of Neurology (EBN) guidelines, covering stroke and cerebrovascular neurology, epilepsy and clinical electrophysiology (EEG), neuroimmunology and multiple sclerosis, movement disorders, neuromuscular diseases and electromyography (EMG/NCS), cognitive neurology and dementia, headache and facial pain, neuro-infectious diseases, and neuro-critical care. Note on format and language: While the official written SNG examination is administered in English and the oral/practical examination is conducted in Swiss national languages (German/French) or English, this question bank is an English-language multiple-choice study adaptation created by OpenExamPrep—not an official SNG or SIWF examination release—specifically designed to train high-yield clinical decision-making, electrophysiological interpretation, neuroimaging analysis, and guideline-based therapeutic management.

Assessment

Three-part qualifying examination administered across two sessions: 1) Written Multiple-Choice examination (in English, 4-hour session covering the breadth of clinical neurology and neurophysiology), 2) Structured oral case-based examination, and 3) Practical clinical examination testing bedside neurological examination, localization, diagnostic synthesis, and patient management before senior examiners.

Time Limit

240 minutes written examination (4 hours) plus structured oral and practical clinical examination stations

Passing Score

Criterion-referenced standard passing score on the written MCQ paper and structured passing evaluations across all oral and practical clinical stations by the SNG board of examiners

Exam Fee

SNG Examination fee: CHF 1,500 (SAYN members) / CHF 2,250 (non-members); SIWF FMH Title Application fee: CHF 1,000–2,500 (Schweizerisches Institut für ärztliche Weiter- und Fortbildung (SIWF / FMH) and Schweizerische Neurologische Gesellschaft (SNG / SSN))

Facharzt FMH Neurologie Exam Content Outline

20%

Cerebrovascular Disease & Acute Stroke

Pathophysiology, emergency neuroimaging (CT/CTA/CTP, MRI/MRA/DWI-FLAIR mismatch), intravenous thrombolysis (alteplase, tenecteplase), endovascular mechanical thrombectomy (DAWN, DEFUSE-3, EXTEND-IA criteria), intracerebral hemorrhage (ICH) blood pressure control and anticoagulant reversal (idarucizumab, andexanet alfa, 4-factor PCC), subarachnoid hemorrhage, cerebral venous sinus thrombosis, cervical artery dissection, and secondary stroke prevention.

16%

Epilepsy, Seizure Disorders & Clinical Neurophysiology

Classification of epileptic seizures and epilepsies (ILAE 2017/2024), status epilepticus stepped protocols (ESETT trial: lorazepam, levetiracetam, fosphenytoin, valproate, anesthetics), antiseizure medications pharmacology, pharmacogenomics (HLA-B*1502, HLA-A*3101) and teratogenicity, EEG interpretation (focal/generalized discharges, 3 Hz spike-wave, LPDs/PLEDs, triphasic waves, hypsarrhythmia), and psychogenic non-epileptic seizures.

16%

Neuroimmunology, Multiple Sclerosis & Autoimmune Encephalitis

McDonald 2017 diagnostic criteria, CSF oligoclonal bands, acute relapse management, disease-modifying therapies for relapsing and progressive MS (ocrelizumab, natalizumab with PML/JCV risk stratification, sphingosine-1-phosphate modulators, cladribine, ofatumumab), Neuromyelitis Optica Spectrum Disorder (anti-AQP4, satralizumab, inebilizumab, eculizumab), MOGAD, and autoimmune encephalitis syndromes (anti-NMDAR, anti-LGI1, anti-CASPR2).

14%

Movement Disorders & Extrapyramidal Syndromes

Parkinson's disease diagnostic criteria (MDS), motor complications (wearing-off, dyskinesia), pharmacotherapy (levodopa, COMT/MAO-B inhibitors, dopamine agonists and impulse control disorders), deep brain stimulation (STN vs GPi), atypical parkinsonian syndromes (PSP, MSA, CBD, DLB), Huntington's disease, Wilson's disease, dystonias, essential tremor, and restless legs syndrome.

16%

Neuromuscular Diseases, ALS, Myopathies & EMG/NCS

Amyotrophic lateral sclerosis (ALS: revised El Escorial/Gold Coast criteria, riluzole, non-invasive ventilation), Myasthenia Gravis (anti-AChR, anti-MuSK, thymectomy, FcRn antagonists), Lambert-Eaton syndrome, Guillain-Barré syndrome (AIDP, Miller Fisher syndrome with anti-GQ1b), CIDP, hereditary neuropathies (CMT1A), inflammatory myopathies (dermatomyositis, inclusion body myositis, IMNM), and electrodiagnostic principles (EMG denervation vs myopathic patterns, NCS demyelinating vs axonal features).

Dementia, Cognitive Neurology & Prion Diseases

Alzheimer's disease CSF biomarkers (Aβ42, p-tau, t-tau) and anti-amyloid therapeutics (lecanemab, donanemab with ARIA monitoring), behavioral variant Frontotemporal Dementia (bvFTD), Primary Progressive Aphasia variants, idiopathic Normal Pressure Hydrocephalus (Hakim triad, tap test), Sporadic Creutzfeldt-Jakob Disease (sCJD: RT-QuIC, cortical ribboning, PSWCs), and reversible encephalopathies.

10%

Headache, Facial Pain, Neuro-Infections & Neuro-Critical Care

Migraine pathophysiology, acute and preventive therapies (CGRP antagonists, gepants, botulinum toxin A), cluster headache, idiopathic intracranial hypertension, spontaneous intracranial hypotension, trigeminal neuralgia, giant cell arteritis, acute bacterial and viral meningitis/encephalitis (HSV-1, tick-borne encephalitis/FSME, neuroborreliosis/Bannwarth syndrome), neuro-oncology (glioma IDH/1p19q/MGMT, brain metastases, paraneoplastic syndromes), and ICP management.

How to Pass the Facharzt FMH Neurologie Exam

What You Need to Know

Passing score: Criterion-referenced standard passing score on the written MCQ paper and structured passing evaluations across all oral and practical clinical stations by the SNG board of examiners
Assessment: Three-part qualifying examination administered across two sessions: 1) Written Multiple-Choice examination (in English, 4-hour session covering the breadth of clinical neurology and neurophysiology), 2) Structured oral case-based examination, and 3) Practical clinical examination testing bedside neurological examination, localization, diagnostic synthesis, and patient management before senior examiners.
Time limit: 240 minutes written examination (4 hours) plus structured oral and practical clinical examination stations
Exam fee: SNG Examination fee: CHF 1,500 (SAYN members) / CHF 2,250 (non-members); SIWF FMH Title Application fee: CHF 1,000–2,500

Keys to Passing

Work through all 100 available questions
Review every answer and explanation
Track weak areas and revisit them
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Facharzt FMH Neurologie Study Tips from Top Performers

1Master Acute Stroke Reperfusion Windows & Perfusion Criteria: Know exact time windows for IV thrombolysis (<4.5h, WAKE-UP/EXTEND mismatch criteria), mechanical thrombectomy criteria in the anterior circulation (0–6h standard, 6–24h DAWN/DEFUSE-3 mismatch criteria), and basilar artery occlusion protocols.

2Understand Stepped Status Epilepticus Protocols: Memorize the exact first-line (IV lorazepam/midazolam), second-line (IV levetiracetam, fosphenytoin, or valproate sodium based on the ESETT trial), and third-line anesthetic regimens (propofol, midazolam infusion to burst suppression), as well as EEG criteria for non-convulsive status epilepticus (Salzburg criteria).

3Differentiate Demyelinating Syndromes & Antibody Biomarkers: Be proficient in differentiating MS (McDonald 2017 criteria, CSF oligoclonal bands) from NMOSD (anti-AQP4, longitudinally extensive transverse myelitis, area postrema syndrome) and MOGAD (anti-MOG, bilateral optic neuritis, conus lesions), and know which MS therapies are contraindicated in NMOSD.

4Interpret Neurophysiology & EMG/NCS Parameters: Review key electrodiagnostic findings, such as distinguishing active denervation (fibrillation potentials, positive sharp waves) from chronic reinnervation, and differentiating demyelinating conduction block and slowed conduction velocities from axonal amplitude reductions.

5Recognize Movement Disorder Pathognomonic Features & Pharmacotherapy: Differentiate typical Parkinson's disease from atypical parkinsonian syndromes (hummingbird sign in PSP, hot cross bun sign and severe dysautonomia in MSA, alien limb in CBD), and know the management of motor fluctuations, dopamine agonist-induced impulse control disorders, and deep brain stimulation targets.

Frequently Asked Questions

What is the Facharzt FMH für Neurologie title?

The Facharzt FMH für Neurologie is the federally recognized Swiss medical specialist title granted by the SIWF (Swiss Institute for Postgraduate and Continuous Medical Training) and FMH (Swiss Medical Association). It certifies full independent clinical competency to practice neurology across outpatient, inpatient, and emergency settings in Switzerland following 6 years of postgraduate training and successful completion of the SNG specialist examination.

How is the Swiss Neurology specialist examination (Facharztprüfung) structured?

The SNG Facharztprüfung comprises three distinct components administered across two sessions: 1) A written Multiple-Choice examination (conducted in English, lasting 4 hours), 2) A structured oral examination evaluating clinical case vignettes and management, and 3) A practical clinical examination testing bedside neurological examination technique, neurophysiological interpretations (EEG, EMG/NCS), and diagnostic synthesis before senior examiners.

In what language is the examination administered?

The written Multiple-Choice component is conducted entirely in English, aligning with European training standards (EBN/EAN). The oral and practical clinical examination components can be taken in German, French, or English depending on the candidate's preference and center availability.

When can neurology trainees take the Facharztprüfung?

Candidates are eligible to register for the written examination during their senior residency years (typically year 5 or 6 of accredited training). The oral and practical components must be completed within 3 years of passing the written examination.

What guidelines and evidence form the core basis of the examination?

The examination tests clinical reasoning and factual knowledge based on Swiss Neurological Society (SNG) guidelines, European Academy of Neurology (EAN) guidelines, European Stroke Organisation (ESO) recommendations, and major international neurological landmark trials.

Why is this practice bank presented in English?

The official written Swiss SNG Facharztprüfung is administered exclusively in English. Presenting this 100-question practice bank in English directly mirrors the language, structure, and clinical terminology encountered on the real written specialist examination.

100+ Free Facharzt FMH Neurologie Practice Questions

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