47 Diseases of the Cranial Nerves

Question 1

Acute onset of facial diplegia associated with parotid gland swelling from Sarcoidosis

Answer 1

Uveoparotid fever or Heerfordt syndrome p.1397

Question 2

Triad of Recurrent facial paralysis, labial edema, plication of the tongue. Complement levels are normal despite angioneurotic edema. Biopsy of the lip reveal granulomatous inflammation

Answer 2

Melkersson-Rosenthal syndrome p.1397

Question 3

Found in females, characterized by disappearance of fat in the dermal and subcutaneous tissues

Answer 3

Parry-Romberg syndrome p.1397

Question 4

Anomalous or aberrant regeneration of the 7th nerve results in synkinesis. Lateral movt of jaw causes involuntary closure of eyelids

Answer 4

Jaw winking phenomenon or Wartenberg or Inverse Marcus-Gunn sign p.1398

Question 5

Usual cause of hemifacial spasms. Affects women more than men, 5th or 6th decade

Answer 5

Compressive lesion of the facial nerve usually by a tortuous branch of the basilar artery p.1398

Question 6

Pathophysiology of hemifacial spasms?

Answer 6

Focal demyelination at the site of nerve root compression by the vessel. p.1398

The demyelinated axon is presumes to activate adjacent nerve fibers by ephaptic transmission

Question 7

Medical management for hemifacial spasms

Answer 7

Carbamazepine 600 tp 1,200mg/day p.1398

Question 8

Fine rippling activity of all the muscles of one side of the face. Most often in the course of multiple sclerosis or a brainstem glioma and disorders of the NMJ

Answer 8

Facial myokymia p.1398

Question 9

EMG pattern of facial myokymia?

Answer 9

Spontaneous asynchronous discharge of adjacent motor units, appearing singly or in doublets or triplets at a rate varying from 30 to 70 cycles per second p.1398