CN VI Palsy Flashcards
What are the 2 clinical findings of CN VI palsy?
- Horizontal diplopia worse in distance
2. Increasing esodeviation toward side of palsy
What type of Duane’s retraction syndrome mimics CN VI palsy?
Type 1 - abduction deficit (most common type
DRS type 2 looks like what?
Adduction deficit with normal abduction
DRS type 3 looks like what?
Ab and Adduction deficit
This may mimic an abduction deficit due to a resulting convergence that prevents full abduction in either eye.
Spasm of the near reflex
In a true neurogenic CN VI palsy, what will the patient’s saccades look like on adduction?
Slow, Glissades = palsied eye trails behind unaffected eye
When performing forced ductions on a possible CN VI palsy, what will be the result?
(-) FD test = eye will move out easily, negative restriction
For a CN VI palsy, will ductions or versions be better?
Ductions > Versions
What is considered the gaze center?
CN VI nucleus
A nuclear lesion of CN VI will cause what finding?
- ipsilateral eye can’t abduct
- contralateral eye cant adduct
= gaze palsy!
When is the one time an abduction deficit becomes a medical emergency?
when papilledema is present
A clivus tumor can give us a unilateral or bilateral CN VI palsy due to metastasis from what cancers?
- Breast
- Prostate
- Lung
CN VI travels most ____ in the cavernous sinus (closest to ICA).
Travels most medially
- closest to ICA
Tolossa-Hunt syndrome is what?
Painful inflammation of cavernous sinus
What is the work-up for an adult with a CN VI palsy?
- rule out GCA and diabtes
2. MRI w/ GAD
