Lesions Flashcards
Causes of an optic nerve lesion
Papilloedema due to raised ICP
Optic neuritis
Causes of raised ICP
SOL
Cerebral oedema
Infection
Hydrocephalus
Clinical presentation of raised ICP optic nerve impingement
Visual changes on coughing / sneezing
Visual field defect
Signs on fundoscopy of papilloedema
blurred disc margins
increased of cup to disc ratio
usually bilateral
Causes of optic neuritis
MS
Infection - usually viral
Clinical features of optic neuritis
Acute monocular vision loss
Eye pain on movement
Central scotoma
Relative afferent pupillary defect (dilation of pupil when light swings from unaffected eye to the affected eye)
Causes of optic atrophy
Optic nerve compression - tumour
Raised ICP
Thiamine / B12 deficiency
Presentation of optic atrophy
Reduced visual acuity
Central scotoma
Pallor of the disc on fundoscopy
RAPD
Cavernous sinus pathology linked with which nerves?
3,4,5,6
Presentation of CN 3 lesion
Eye turned down and out
Pupil dilated
Ptosis
CN 4 innervates?
Superior oblique
Lesion of CN4 presents as
diplopia on downwards gaze when the eye is adducted
Causes of CN3 lesions
Vascular infarct
Trauma
DM
Cavernous sinus pathology
Causes of CN4 lesions
Vascular infarct
Trauma
Cavernous sinus pathology
3 branches of the trigeminal nerve
ophthalmic
maxillary
mandibular
Trigeminal neuralgia presentation
sharp stabbing pain
usually in mandibular region
worse on washing / shaving / eating
Treatment of trigeminal nerve
Carabamazepine - most effective
Abducens nerve controls?
Lateral rectus nerve
Presentation of CN6 nerve palsy
failure of abduction of the affected eye
diplopia on abduction of the affected eye
Causes of CN6 nerve palsy
trauma
diabetes
vascular infarct
Cavernous sinus pathology
Bells palsy definition
acute LMN facial nerve palsy (unknown origin)
UMN lesion can cause what type of palsy
incomplete, just lower half of the face
due to duel supply from the cortex of the nerves innervating the upper face
Causes of CN7 lesion
Bells palsy
Stroke
Infection - Ramsey Hunt (possible vesicles in the external auditory canal)
DM
How quickly do Bells palsys usually recover
80% in 2m
Causes of a CN8 lesion
Tumours MS Trauma Infection - meningitis Gentimicin
Cause of menieres disease
Fluid overload due to failure of endolymph reabsorption
Presentation of menieres disease
Episodic vertigo
Fluctuating deafness
Tinnitus
Recurrent attacks
Bulbar palsy definition
LMN lesion of 9,10,11 and 12
Pseudobulbar palsy definition
UMN lesion of CN 9,10,112 and 12
Causes of bulbar palsy
GB syndrome
MN disease
Tumour
Pseudobulbar palsy causes
stroke
MS
MND
causes of mixed UMN and LMN CN lesions
MND
Presentation of bulbar palsy
Speech
Jaw jerk
Gag reflex
Tongue
Quiet and hoarse speech Absent jaw jerk Absent or reduced gag reflex Dysphagia Nasal regurg of food wasted tongue, flaccid w/ fasciculation's
Presentation of pseudobulbar palsy
Speech
Jaw jerk
Gag reflex
Tongue
Slow monotonous speech Brisk jaw jerk Brisk gag reflex Dysphagia Small spastic tongue
May be UMN signs in the arms
