Brainstem & CN syndromes (Pieper) Flashcards
a lacunar ischemic stroke affecting the midbrain, with CNIII signs and contralateral weakness
Weber syndrome
a lacunar ischemic stroke affecting the lateral medulla, resulting in symptoms of horner’s, hiccups, contra body numbness, ipsi facial numbness, incoordination, vertigo and dysphagia
wallenberg syndrome (lateral medullary syndrome)
lacunar ischemic stroke (perforators) that causes contra hemiparesis and ipsi tongue weakness
medial medullary syndrome
post-infectious immune reaction in which anti-GQ1b antibodies attack the Schwann cells, causing peripheral demyelination of axons
Bickerstaff encephalitis
*other non-vascular events that affect the brainstem are sarcoid and tumor
common nerve disorder in diabetics in which the eye appears to be “down and out”; what must be ruled out?
CN III palsy; must rule out posterior communicating aneurysm, as the Pcomm is located next to CN III as it exits through the subarachnoid space
A patient presents with facial pain which is worst with touching, cold, chewing and brushing teeth. You determine the cause to be trigeminal neuralgia. What is the best treatment option?
anti-epileptics, namely Carbamazepine
treatment for Bell’s palsy (CN VII palsy)
steroids
slow growing tumor of Schwann cells that wrap around this CN in the cerebellar pontine angle, resulting in haring loss and imbalance
CN VIII (acoustic Schwannoma)
multiple cranial nerve palsy that affects nerves in the retroparotid/retropharyngeal space
villaret’s syndrome
inflammatory disorder of unknown etiology that affects multiple nerves in the cavernous sinus (III, IV, V1, 2, VI)
tolosa-hunt syndrome
multiple cranial nerve palsies that are not otherwise generalizable to one location must be evaulated for this condition - leptomeningeal metastasis of a number of different tumor types, with poor prognosis
carcinomatous meningitis
*gold standard work up for this - enhanced MRI and lumbar puncture
