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Phase 3a - Neurology > Cranial Nerve Issues > Flashcards

Cranial Nerve Issues Flashcards

1
Q

What is Bell’s Palsy?

A

A sudden, unilateral, idiopathic lower motor neuron facial nerve palsy.

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2
Q

True/False: Bell’s Palsy affects both the upper and lower parts of the face.

A

true

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3
Q

Bell’s Palsy primarily affects cranial nerve number ____.

A

Seven (VII)

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4
Q

Which age groups are most commonly affected by Bell’s Palsy?

A

It can affect any age group but is most common between 15–45 years.

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5
Q

True/False: Bell’s Palsy has no gender predilection.

A

true

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6
Q

What is the presumed cause of Bell’s Palsy?

A

Reactivation of latent herpes simplex virus (HSV-1) or varicella-zoster virus (VZV).

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7
Q

Bell’s Palsy results in inflammation and swelling of the ______ nerve within the facial canal.

A

Facial

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8
Q

What are the key symptoms of Bell’s Palsy?

A

Sudden onset of facial weakness, inability to close the eye, drooping of the mouth, loss of forehead wrinkling, and impaired taste on the anterior two-thirds of the tongue.

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9
Q

True/False: Bell’s Palsy can present with pain around the ear.

A

true

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10
Q

Patients with Bell’s Palsy may have ______, or an increased sensitivity to sound on the affected side.

A

Hyperacusis.

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11
Q

How is Bell’s Palsy diagnosed?

A

Clinically, based on unilateral lower motor neuron facial palsy and exclusion of other causes.

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12
Q

True/False: Imaging is typically required to diagnose Bell’s Palsy.

A

False. Imaging is reserved for atypical cases.

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13
Q

Upper motor neuron lesions spare the ______, unlike Bell’s Palsy.

A

Forehead.

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14
Q

Name two differential diagnoses for Bell’s Palsy.

A

Stroke and Ramsay Hunt Syndrome.

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15
Q

True/False: Lyme disease can mimic Bell’s Palsy.

A

True.

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16
Q

Ramsay Hunt Syndrome involves facial paralysis and ______ due to VZV reactivation.

A

Vesicular rash in the ear.

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17
Q

What is the first-line treatment for Bell’s Palsy?

A

Prednisolone within 72 hours of symptom onset.

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18
Q

True/False: Antiviral therapy is routinely recommended for Bell’s Palsy.

A

False. Antivirals are only considered in severe cases or suspected viral reactivation.

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19
Q

Eye care, including ______ and artificial tears, is crucial in Bell’s Palsy to prevent corneal damage.

A

Eye patching.

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20
Q

What percentage of Bell’s Palsy cases recover fully without treatment?

A

Around 70–80%.

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21
Q

True/False: Residual weakness after Bell’s Palsy is uncommon.

A

True, but it occurs in some cases.

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22
Q

Prognosis is poorer in older individuals and those with complete ______ paralysis at onset.

A

Facial.

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23
Q

What is bulbar palsy?

A

A lower motor neuron lesion affecting the cranial nerves IX, X, XI, and XII, which control muscles involved in speech, swallowing, and other bulbar functions.

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24
Q

True/False: Bulbar palsy exclusively affects upper motor neurons.

A

False. It affects lower motor neurons.

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25
Q

Bulbar palsy results from damage to the ______ in the brainstem or their nuclei.

A

Cranial nerve motor nuclei.

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26
Q

Name three potential causes of bulbar palsy.

A

Motor neuron disease (ALS), brainstem stroke, and Guillain-Barré Syndrome.

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27
Q

True/False: Myasthenia gravis can cause bulbar palsy.

A

True

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28
Q

Peripheral neuropathies, such as ______, can contribute to bulbar palsy.

A

Guillain-Barré Syndrome.

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29
Q

What are the primary symptoms of bulbar palsy?

A

Dysarthria, dysphagia, nasal regurgitation, and weak or absent gag reflex.

30
Q

True/False: Patients with bulbar palsy may have a nasal, “breathy” voice.

A

True

31
Q

Atrophy and ______ of the tongue are characteristic findings in bulbar palsy.

A

Fasciculations.

32
Q

What is a key differential diagnosis of bulbar palsy?

A

Pseudobulbar palsy.

33
Q

True/False: Pseudobulbar palsy is caused by bilateral upper motor neuron lesions.

A

True

34
Q

Unlike bulbar palsy, pseudobulbar palsy presents with ______ reflexes such as an exaggerated gag reflex.

A

Hyperactive

35
Q

What investigations are commonly performed for suspected bulbar palsy?

A

MRI of the brainstem, EMG/NCS, and blood tests for autoimmune and infectious causes.

36
Q

True/False: EMG can confirm lower motor neuron involvement in bulbar palsy.

A

True

37
Q

MRI is used to exclude structural lesions such as ______ or brainstem tumors.

A

Strokes

38
Q

What is the primary approach to managing bulbar palsy?

A

Treat the underlying cause, supportive care for speech and swallowing, and nutritional support.

39
Q

True/False: Patients with bulbar palsy may require PEG feeding due to severe dysphagia.

A

True

40
Q

______ therapy can help manage dysarthria in bulbar palsy.

A

Speech

41
Q

What are two major complications of bulbar palsy?

A

Aspiration pneumonia and malnutrition.

42
Q

True/False: Respiratory failure is a potential complication of severe bulbar palsy.

A

True

43
Q

Early identification of ______ is crucial to prevent aspiration-related complications in bulbar palsy.

A

Dysphagia.

44
Q

What factors affect the prognosis of bulbar palsy?

A

The underlying cause, severity of symptoms, and response to treatment.

45
Q

True/False: Prognosis is generally poor in progressive conditions like ALS.

A

True

46
Q

Non-progressive causes of bulbar palsy, such as Guillain-Barré Syndrome, may have a ______ prognosis.

A

Better

47
Q

What is Horner’s Syndrome?

A

A neurological syndrome caused by disruption of the sympathetic nerves supplying the eye and face.

48
Q

True/False: Horner’s Syndrome is always bilateral.

A

false

49
Q

Horner’s Syndrome is characterized by ______ ptosis, miosis, and anhidrosis.

A

Partial

50
Q

What are the three neuronal levels of the sympathetic pathway involved in Horner’s Syndrome?

A

First-order (hypothalamus to spinal cord), second-order (spinal cord to sympathetic chain), and third-order (sympathetic chain to the face and eyes).

51
Q

True/False: A lesion at the level of the carotid artery can cause Horner’s Syndrome.

A

true

52
Q

Third-order neuron damage in Horner’s Syndrome often involves the ______ ganglion.

A

Superior cervical.

53
Q

What are the hallmark features of Horner’s Syndrome?

A

Ptosis, miosis, anhidrosis, and enophthalmos (less prominent).

54
Q

True/False: Ptosis in Horner’s Syndrome is due to levator palpebrae superioris weakness.

A

False. It is due to dysfunction of Müller’s muscle.

55
Q

The absence of sweating in Horner’s Syndrome occurs on the ______ side of the face.

A

Affected

56
Q

List three possible causes of Horner’s Syndrome.

A

Stroke, carotid artery dissection, and Pancoast tumor.

57
Q

True/False: Horner’s Syndrome can result from a traumatic spinal cord injury.

A

true

58
Q

A ______ tumor affecting the apex of the lung can compress the sympathetic chain, leading to Horner’s Syndrome.

A

Pancoast

59
Q

What pharmacological test can be used to confirm Horner’s Syndrome?

A

Cocaine or apraclonidine eye drop test.

60
Q

True/False: MRI is the gold standard imaging to investigate the cause of Horner’s Syndrome.

A

False. Both MRI and CT can be used depending on the suspected etiology.

61
Q

Imaging of the ______ artery is recommended in suspected carotid artery dissection.

A

Internal carotid.

62
Q

How do central and peripheral causes of Horner’s Syndrome differ in presentation?

A

Central lesions often affect both sweating and eye symptoms, while peripheral lesions may only involve the eye.

63
Q

True/False: A central cause of Horner’s Syndrome typically spares facial sweating.

A

False. It often affects sweating.

64
Q

Peripheral causes of Horner’s Syndrome commonly involve damage to the ______ sympathetic chain.

A

Cervical

65
Q

What is the primary focus of treatment for Horner’s Syndrome?

A

Treating the underlying cause.

66
Q

True/False: Horner’s Syndrome itself requires specific pharmacological treatment.

A

False. Management targets the underlying pathology.

67
Q

Urgent investigation is required for Horner’s Syndrome caused by suspected ______ artery dissection.

A

Carotid

68
Q

What is a potential life-threatening cause of Horner’s Syndrome that must not be missed?

A

Carotid artery dissection leading to stroke.

69
Q

True/False: Pancoast tumors causing Horner’s Syndrome may indicate advanced malignancy.

A

true

70
Q

Horner’s Syndrome associated with neck pain may suggest ______ as a cause.

A

Carotid dissection

Phase 3a - Neurology (18 decks)

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