Disorders of Cranial Nerves

Question 1

which nerve constricts the pupil and by what muscle

Answer 1

occulomotor by constrictor pupillae (circular one)

Question 2

4 reflexes of cranial nerves

Answer 2

pupillary reflex, corneal reflex, jaw jerk, gag reflex

Question 3

cranial nerve nuclei of the midbrain

Answer 3

III and IV

Question 4

cranial nerve nuclei of the pons

Answer 4

V, VI and VII

Question 5

cranial nerve nuclei of the medulla

Answer 5

IX, X, XI and XII

Question 6

which cranial nerve has its nuclei in the pontomedullary junction

Answer 6

VIII

Question 7

what causes optic neuritis

Answer 7

demyelination of the optic nerve (common in MS)

Question 8

features of optic neuritis

Answer 8

unilateral, reduced acuity, loss of saturation, pain on movement

Question 9

sympathetic/parasympathetic dilates the pupil

Answer 9

sympathetic

Question 10

causes of dilated pupil

Answer 10

youth, darkness, anxiety, excitement, mydriatic eye drops, amphetamine, cocaine overdose, 3rd nerve palsy, drain death

Question 11

causes of a constricted pupil

Answer 11

old age, brightness, miotuc eye drops, opiate overdose, horner’s syndrome

Question 12

which nerve is responsible for ptosis

Answer 12

occulomotor

Question 13

in compressive third nerve palsy caused by raised ICP or a posterior artery aneurysm the pupil is spared/affected

Answer 13

affected - it is also painful

Question 14

causes of an isolated 6th nerve palsy

Answer 14

idiopathic
diabetes
meningitis
raised ICP

Question 15

true/false cerebellar disease can cause nystagmus

Answer 15

true

Question 16

causes of nystagmus

Answer 16

congenital
visual impairment
central vestibular/brainstem disease
cerebellar disease
peripheral vestibular problem
toxins such as alcohol

Question 17

what is neuralgia

Answer 17

severe pain following the course of a nerve, burning or stabbing

Question 18

what is trigeminal neuralgia

Answer 18

pain in trigeminal sensory areas often from a trigger

Question 19

what is trigeminal neuralgia most commonly caused by

Answer 19

a loop of artery or vein in the posterior fossa compressing the 5th nerve

Question 20

medical treatment of trigeminal neuralgia

Answer 20

carbamazepine (relieves pain)

Question 21

when would surgery be neccessary in trigeminal neuralgia

Answer 21

when it is being mediciation resistant

Question 22

what often precedes facial nerve (Bell’s) palsy

Answer 22

pain behind the ear

Question 23

bell’s palsy is upper/lower motor neuron

Answer 23

low motor neuron

Question 24

treatment of bell’s palsy

Answer 24

steroids

Question 25

UMN of facial nerve causing facial paralysis

Answer 25

stroke or a tumour

Question 26

where is the LMN of the facial nerve

Answer 26

starts in facial nerve nucleus in pons

Question 27

difference between facial paralysis from stroke vs bell’s palsy

Answer 27

stroke usually spares the forehead

Question 28

what is vestibular neuronitis

Answer 28

sudden onset of disabling vertigo and n+v

Question 29

what is thought to cause vestibular neuronitis

Answer 29

a latent infection of herpes simplex virus in vestibular ganglion

Question 30

what is dysarthria

Answer 30

unclear speech and slurring

Question 31

what is dysphagia

Answer 31

difficulty swallowing

Question 32

what conditions do dysphagia and dysarthria occur in

Answer 32

bulbar and pseudobulbar palsy

Question 33

where is the problem in bulbar palsy

Answer 33

LMN lesion bilaterally of nerves IX, X, XI and XII

Question 34

what diseases cause bulbar palsy

Answer 34

MND, polio, tumours, sphyilis

Question 35

where is the problem in pseudobulbar palsy

Answer 35

UMN lesion bilaterally, such as in the internal capsules

Question 36

condition that can give a brisk jaw reflex and gag reflex

Answer 36

pseudobulbar palsy

Question 37

condition where you would see a spastic immobile tongue

Answer 37

pseudobulbar palsy

Question 38

condition where you would see a wasting fasciculating tongue

Answer 38

bulbar palsy