Neurological conditions

Question 1

name the 2 cardinal features of neuro-opthalmic disease

Answer 1

-eye movement defects (double vision) and visual defects (visual acuity/field loss)

Question 2

name 6 causes of neuro-opthalmic disease

Answer 2

vascular disease
tumours
trauma demyelination
inflammation
infection
congenital abnormalities

Question 3

CNVI Palsy

• muscle involved and normal action
• presentation
• causes (4)

Answer 3

• causes lateral rectus palsy, LR usually causes abduction
• convergent squint i.e. cross eyed

-microvascular
raised ICP (papilloedema)
tumour
congenital

Question 4

CNIV palsy

• muscle involved and normal action
• presentation
• causes (4)

Answer 4

-superior oblique, causes depression in adduction and weak abduction

-eye adducted and looking up i.e. in and up
diplopia in looking down

-head tilt in children
congenital
bilateral in trauma
microvascular or tumour

Question 5

CNIII palsy

• muscles involved (6)
• presentation (2)
• causes (6)

Answer 5

-medial/inferior/superior rectus, inferior oblique, sphinter pupillae, levator palpebrae superioris

-eye in abduction looking down i.e. down and out
also pupillary dilation and ptosis

-microvascular
tumour
aneurysm
MS
congenital
raised ICP if the temporal lobe herniates through tenurial notch

Question 6

inter-nuclear opthalmoplegia (INO)

• what is impaired in the affected eye
• due to
• causes

Answer 6

• adduction

- injury/dysfunciton of the medial longitudinal fasiculus (heavily myelinated tract allowing conjugate eye movement)

Question 7

describe the pattern of optic nerve defects

-optic neuritis presentation

Answer 7

either horizontal or complete

-progressive unilateral visual loss
pain behind eye, worse on movement
colour desaturation
central scotoma
gradual recovery over weeks

Question 8

Give three things that can occur in the optic chasm to cause visual field defects
-name the visual defect that occurs

Answer 8

pituitary rumour
craniopharyngioma
Meningioma

-bi-temporal field defect

Question 9

Name the pattern of visual defect with optic tracts and their radiations pathology

Answer 9

homonomous defects
macula not spared
Quadrantanopia
incongruous

Question 10

Name the pattern of visual defect with occipital cortex pathology

Answer 10

homonomous defect
macular sparing
congrous