CN II

Question 1

5 Causes of papilledema

Answer 1

1. SOL
2. hydrocephalus (obstructive/communicating)
3. idiopathic intracranial HTN (headache, N+V, pulsatile tinnitus, double vision)
4. Hypertension (grade IV)
5. Central venous sinus thrombosis
6. Central retinal vein occ

Question 2

5 causes of optic neuropathy

Answer 2

1. MS
2. Metabolic - Vit B12 def
3. Ischemia
4. Toxic - chloroquine, alcohol, ethambutol❤️
5. Infection - infective mononucleosis

Question 3

6 causes of constricted pupil

Answer 3

1. Horner’s (reactive to light n accomm, partial ptosis, enophthalmos, anhidrosis)
   Check for lat med sx

2. Argyll Robertson (not reactive to light but accommodates)
Check reflexes (reduced in tabes)

3. Pontine lesion
4. Pilocarpine drops
5. Old age
6. Narcotics

Question 4

6 causes of pupillary dilatation

Answer 4

1. Third nerve lesion (eyes down and out, complete ptosis, no rxn to light or accomm)
2. Adie’s pupil (x rxn to light but mildly to accomm, decreased tendon reflexes)
3. Mydriatics
4. Iridectomy, Lens implant, iritis
5. Trauma, deep coma, cerebral death
6. Congenital

Question 5

Causes of tunnel vision

Answer 5

Glaucoma
Papilledema
Syphillis

Question 6

Causes of bitemporal hemianopia

Answer 6

Pituitary tumour
Craniopharyngioma
Suprasellar meningioma

Question 7

Causes of upper quadrant homonymous hemianopia

Answer 7

Temporal lobe lesion eg
Vascular
Tumour

Question 8

Causes of lower quadrant homonymous hemianopia

Answer 8

Parietal lobe lesion

Question 9

5 Causes of optic atrophy

Answer 9

1. Chronic papilledema or optic neuritis
2. Glaucoma
3. Optic nerve pressure or division
4. Ischemia
5. Familial - retinitis pigmentosa, Leber’s disease, friedreichs ataxia

Question 10

Causes of ptosis

Answer 10

1. Myasthenia gravis
2. Horner’s syndrome
3. Myopathy eg inherited mitochondrial myopathies, myotonic dystrophy
4. Miller Fischer sx