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Medicine > Cranial nerve examination > Flashcards

Cranial nerve examination Flashcards

1
Q

What are generalised causes of cranial nerve palsy?

A
  • Diabetes
  • Stroke
  • MS
  • Tumour
  • Sarcoid
  • SLE
  • Vasculitis
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2
Q

Specific causes of olfactory palsy

A
  • Trauma
  • Frontal lobe tumour
  • Meningitis
  • Early signs of parkinsons
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3
Q

Cause of monocular blindness

A
  • MS

- GCA

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4
Q

Causes of bitemporal Hemianopia

A
  • pituitary adenoma

- Internal carotid artery aneurysm

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5
Q

Causes of a homonymous hemianopia?

A
  • anything behind the chiasm

- stroke tumour abscess

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6
Q

Causes of a partial occulomotor palsy

A

Diabetes pupils spared

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7
Q

Causes of a complete occulomotor palsy

A
  • PCA aneurysm

- Raised intracranial pressure with tentorial herniation

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8
Q

Causes of a single trochlea palsy

A
  • Single palsy is rare

- Usualy due to orbit trauma

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9
Q

Causes of a trigeminal palsy

A
  • Idiopathic (trigeminal neuralgia which is neuropathic pain due to nerve lesion or dysfunction)
  • Accoustic neuroma
  • Herpes zoster
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10
Q

Causes of an abducens nerve palsy

A
  • Skull fracture involving petrous temporal bone
  • Nasopharyngeal carcinoma
  • Raised intracranial pressure
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11
Q

Causes of a facial nerve palsy

A
  • LMN (forehead affected)
    • Bell’s palsy
    • Malignant parotid tumour
    • Herpes zoster (ramsay hunt)
  • UMN (forehead spared)
    • Stroke / Tumour
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12
Q

Vestibularcochlear nerve lesion.

A
  • excessive noise level
  • Menieres disease
  • Frosemide
  • Aminoglycoside antibiotics (gentamycin)
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13
Q

palsies to CN 9, 10, 12 Lower Motor Neuron.

A

LMN (bulbar palsy)

  • Motor neuron disease
  • Dipthermia
  • Polio
  • Gullian - Barre syndrome
  • Syringobulbia
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14
Q

Palsies to CN 9, 10, 12 Upper Motor Neuron.

A

UMN

  • Motor neuron disease
  • Bilateral strokes
  • MS
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15
Q

Causes of grouped cranial nerve palsy

e.g cerebellopontine angle tumour (accoustic neuroma or meningioma). Which cranial nerve is affected?

A
  • Corneal reflex lost first
  • Then VII & VIII
  • Then the rest of V
  • sometimes IX & X
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16
Q

Causes of a grouped cranial nerve lesion e.g. paget’s disease of bone - impingment of nerves as they pass through a bony foramen. Which cranial nerve is affected

A

CN V, VII & VIII.

17
Q

Gradenigos syndrome (Complication of otitis media) affects which cranial nerve?

A

CN V & VI

18
Q

Syringobulbia causes palsy to which CN?

A
  • Bulbar palsy IX, X & XII
  • VIII vertigo and nystagmus
  • V facial pain and sensory lost
  • VII sparing
  • may also have Horners syndrome and features of syringomyelia
19
Q

What are upper motor neuron cranial nerve signs

A
  • Facial nerve palsy with forehead sparing (due to bilateral cortical representaion of the forehead
  • Brisk jaw jerk
  • Pseudobulbar palsy
20
Q

Causes of Opthalmoplegia

A
  • Myasthenia gravis
  • Cranial nerve palsy
  • Graves disease
  • Wernickes encephalopathy (particular failure of upward gaze)
  • Progressive supranuclear palsy (particularly failure of downward gaze)
21
Q

Features of internuclear opthalmoplegia

A
  • disorder of conjugate gaze caused by lesion of the medial longitudinal fissure
  • Causes failure of adduction of the affected side
  • in a left sided INO
    • Lateral gaze to left is normal
    • On attempting to look right
      • the right eye abducts
      • The left eye fails to Adduct and remains looking straight ahead
      • Right eye consequently displays nystagmus as it attempts to compensate
  • Convergence is perserved (the left eye can adduct normally as long as the goal is to not lateral gaze
22
Q

What are causes of internuclear opthalmoplegia

A
  • MS (almost always the cause in a young patinet)
  • Stroke
  • Lyme disease and tricyclic antidepressent overdose are rare causes
23
Q

Causes of a bulbar palsy (LMN lesion)

A
  • MND
  • Diptheria
  • Polio
  • Gullian-Barre syndrome
  • Syringobulbia
24
Q

Causes of a pseudobulbar palsy (UMN Lesion)

A
  • MND
  • Bilateral strokes (e.g. internal capsule)
  • MS

Medicine (22 decks)

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