Neurogenic Conditions

Question 1

Diagnosis of MMM

Answer 1

PE = temporalis and masseter pain, inability to open jaw
Elevated serum creatine kinase
Abnormal EMG
Serology for Type 2M muscle Ab titer

Question 2

Treatment on MMM

Answer 2

Immunosuppressive doses of steroids

Question 3

Diagnosis fibrocartinalgenous embolism

Answer 3

Presentation = acute onset paresis/paralysis that is markedly asymmetric, non-painful
MRI = hyperintensity in cord parenchyma on T2 weighted images

Question 4

New nomenclature for GME (granulomatous meningoencephalitis)

Answer 4

MUE (meningoencephalitis of unknown etiology)

Question 5

Treatment for MGE/MUE

Answer 5

Steroids/pred
Later, cytarabine

Question 6

Cranial Nerve I

Answer 6

• OLFACTORY
• smell
• TEST: not routinely tested

Question 7

Cranial Nerve II

Answer 7

• OPTIC
• vision, response to light
• TEST: menace, PLR, obstacle course, tracking moving objects (cotton ball)
• C/S OF DYSFUNCTION: blindness, dilated/unresponsive pupils

Question 8

Cranial Nerve III

Answer 8

• OCULOMOTOR
• motor to extraocular muscles; parasympathetic to pupil
• TEST: physiologic nystagmus, resting eyeball position, PLR
• C/S OF DYSFUNCTION: ventrolateral strabismus, ptosis, dilated pupils, diminished-absent PLR

Question 9

Cranial Nerve IV

Answer 9

• TROCHLEAR
• motor to dorsal oblique muscle
• TEST: resting eyeball position (cats), fundic exam (dogs)
• C/S OF DYSFUNCTION: dorsomedial strabismus (cats), lateral deviation of retinal vein (dogs)

Question 10

Cranial Nerve V

Answer 10

• TRIGEMINAL
• motor to muscles on mastication (mandibular), sensory to face (ophthalmic and maxillary)
• TEST: jaw tone, muscle bulk, sensation to face, cornea, and nasal mucosa
• C/S OF DYSFUNCTION: masticatory muscle atrophy, dropped jaw if bilateral, decreased or absent facial/nasal sensation

Question 11

Cranial Nerve VI

Answer 11

• ABDUCENT
• motor to lateral rectus and retractor bulbi
• TEST: physiologic nystagmus, resting eyeball position
• C/S OF DYSFUNCTION: medial strabismus

Question 12

Cranial Nerve VII

Answer 12

• FACIAL
• motor to muscles of facial expression, parasympathetic to lacrimal glands, sensory (taste) to rostral tongue
• TEST: menace, palpebral, lip retraction, ear movement, Schirmer tear test
• C/S OF DYSFUNCTION: inability to close eyelid/move ear/retract lip, hemifacial tetany, deviation of nasal philtrum (contralateral), dry eye

Question 13

Cranial Nerve VIII

Answer 13

• VESTIBULOCOCHLEAR
• balance, hearing
• TEST: body/head posture, gait, eye movement and position, hearing
• C/S OF DYSFUNCTION: head tilt, vestibular ataxia, nystagmus, positional strabismus, deafness

Question 14

Cranial Nerve IX

Answer 14

• GLOSSOPHARYNGEAL
• sensory and motor to pharynx
• TEST: gag reflex, ability to swallow
  -C/S OF DYSFUNCTION: diminished gag reflex, dysphagia

Question 15

Cranial Nerve X

Answer 15

• VAGUS
• sensory and motor to pharynx, larynx, and viscera
• TEST: gag reflex, oculocardiac reflex
• C/S OF DYSFUNCTION: diminished gag reflex, dysphagia, laryngeal paralysis, megaesophagus

Question 16

Cranial Nerve XI

Answer 16

• ACCESSORY
• motor to trapezius
• TEST: evaluation of muscle mass
• C/S OF DYSFUNCTION: atrophy of trapezius

Question 17

Cranial Nerve XII

Answer 17

• HYPOGLOSSAL
• motor to tongue muscles
• TEST: evaluation of tongue
• C/S OF DYSFUNCTION: atrophy of tongue, inability to retract tongue if bilateral