Cranial Nerve Disorders

Question 1

What is Bell’s palsy?

Answer 1

Idiopathic syndrome that causes damage to the facial nerve

Question 2

Sx of Bell’s palsy?

Answer 2

• Acute onset unilateral LMN facial weakness (classically affects forehead)
• Mild/moderate postauricular otalgia (ear pain)
• Hyperacusis (noise sensitivity)
• Nervus intermedius sx (altered taste + dry mouth)
• Numbness or heaviness in face

Question 3

Ix for Bell’s palsy?

Answer 3

FBC, ESR or CRP
Viral serology (HSV-1,EBV,VZV)

Question 4

Mx of Bell’s Palsy?

Answer 4

• Steroids - 50mg oral prednisolone
• Acicolvir - in some viral cases
• Supportive tx - artificial tears, eye patch, pain mx, physical tharpy including facial exercises

Question 5

What is Horner’s syndrome?

Answer 5

Cdtn characterised by set of sx that occur due to disruption in sympathetic nerve supply to the eye.

The syndrome can be categorised into pre-ganglionic, post-ganglionic, and central causes, depending on the location of the sympathetic nerve interruption.

Question 6

What are the causes of Horner’s syndrome?

Answer 6

• Pancoast tumour
• Stroke
• Carotid artery dissection
• Neck trauma

Question 7

Sx of Horner’s syndrome?

Answer 7

Ptosis - drooping upper eyelid
Miosis - pupil constriction
Anhidrosis - lack of sweating on affected side of face
Enophthalmos - sunken eye
Heterochromia - eye colour change

Question 8

Ix for Horner’s syndrome?

Answer 8

• MRI/CT scan of head,neck and chest
• Bloods - underlying cause

Question 9

Tx of Horner’s syndrome?

Answer 9

Tx of underlying cause

Question 10

Sx of acoustic neuroma?

Answer 10

Cranial nerve dysfunction - affected CN nerves: 5,7,8
Unilateral hearing loss
Tinnitus