TBL 3 Brainstem Abnormalities

Question 1

Discuss symptoms of Horner’s syndrome

Answer 1

symptoms brought on by lack of sympathetic innervation: lack of sweating, flushed face, contracted pupil and droopy eyelid

Question 2

Describe accessory neuropathy.

Answer 2

unilateral dysfunction causes dysfunction in the ipsilateral sternocleigdomastoid and trapezius muscles

Question 3

What are symptoms of hypoglossal neuropathy?

Answer 3

LMN abnormalities of the ipsilateral tongue muscles

Question 4

What areas would be affected by medial medullary syndrome?

Answer 4

hypoglossal nucleus, ascending TTT, medial lemnisucs (of contra dorsal tracts) and the pyramidal tract

Question 5

What symptoms would differ with conductive hearing loss v. sensorineural hearing loss?

Answer 5

conductive would lead to louder sensation of tuning fork on mastoid process than outside ear, where as sensorineural hearing loss

Question 6

What symptoms would you expect with vagus neuropathy?

Answer 6

dysarthria, dysphonia, dysphagia, nasal regurgitation, ipsilateral weakness of palate elevation or diminished ipsilateral gag reflex

Question 7

How would glossopharyngeal neuropathy differ from vagal neuropathy

Answer 7

glossopharygeal neuropathy includes disfuction of the stylopharyngeus muscle while the vagus nerve includes effects to the uvula

Question 8

What are key elements of lateral medullary syndrome?

Answer 8

vestibular issues, Horner’s syndrome, disruption of the spinal nucleus of V and vagal nerve symptoms

Question 9

What is characteristic of abducens neuropathy?

Answer 9

abnormal eye will be unable to fully abduct and this my cause dysconjagacy and diplopia (worsening with gaze in that direction)

Question 10

What is internuclear opthalmoparesis?

Answer 10

unilateral dysfunction of the medial lontigudinal fascicles casing ipsilateral adduction weakness, with preserved convergence; the interneuron in the MLF is interrupted on its way to the oculomotor nucleus)

Question 11

What areas will be affected with medial pontine syndrome?

Answer 11

corticospinal tract, medial lemniscus, interruption of basal pontine nuclei with variation including the face and eye based on posterior/anterior and upper/lower

Question 12

Locked-in syndrome is caused by what type of lesion?

Answer 12

bilateral lesion of the basis pontis which spares the tegmentum (basilar artery occlusion)— sensory is preserved along with some eye function but motor is destroyed

Question 13

Vestibulocochlear neuropathy results in what symptoms?

Answer 13

hearing loss, vertigo, dysequilibrium, nausea, nystagmus

Question 14

Damage to the facial nerve will result in what types of modality loss (motor, sensory, which type of sensory?)

Answer 14

ipsilateral face weakness and hyperacusis (motor) decreased lacrimal activity (parasympathetic), abnormal taste sensation (special sensory)— trigeminal does most of the facial somatosensory

Question 15

How does trigeminal neuropathy differ from facial neuropathy?

Answer 15

centers around somatosensory to the face and the muscles of mastication and symptoms will present in these areas

Question 16

What areas will be affect in lateral pontine syndrome?

Answer 16

somatosensory and LMN abnormaltilties of the ispilateral face and muscles of mastication, vestibulocochlear signs, spinothalamic and Horner’s syndrome

Question 17

What symptoms would you expect from oculomotor neuropathy?

Answer 17

ipsilateral ptosis, **anisocoria that worsens with light, down and out eye

Question 18

Trochlear neuropathy would affect which movement of the eye?

Answer 18

inability to depress the eye when abducted and weakness in intorsion

Question 19

What areas are affected in medial midbrain syndrome?

Answer 19

oculomotor disturbances and contralateral trochlear

Question 20

How does lateral midbrain syndrome differ from medial midbrain syndrome?

Answer 20

it contains the cerebral peduncles, TTT and spinothalamic tracts along with medial and lateral lemnisci— this syndrome includes motor deficits of the body as well as sensory abnormalities to the face.