The Eye in Neurological Disease Flashcards
What are the cardinal features of neuro-ophthalmic disease?
Eye movement defects = double vision
Visual defects = visual acuity, field loss
What are the possible aetiologies of neuro-ophthalmic disease?
Vascular disease, tumours, trauma, demyelination, infection, inflammation, congenital abnormalities
What are some investigations done for neuro-ophthalmic disease?
Full medical and neurological examination, blood tests. MRI
What are causes of ocular motility defects?
CN III, CN IV, CN VI, internuclear, supranuclear
What muscle is affected by CN VI palsy?
Lateral rectus = loss of abduction
What are some causes of CN VI palsy?
Microvascular, raised intracranial pressure, tumour, congenital
What may be a sign of CN VI palsy?
Papilloedema
What muscle is affected by CN IV palsy?
Superior oblique = loss of intorsion and depression in adduction (also loss of weak abduction)
What may be a sign of CN IV palsy?
Loss of incyclotorsion during head tilt
What are the causes of CN IV palsy?
Congenital decompensation, microvascular, tumour, closed head trauma (if bilateral)
What is a sign of CN III palsy?
Eye faces down and out
What muscles may be affected by CN III palsy?
Medial rectus, inferior rectus, superior rectus, sphincter pupillae, levator palpebrae superioris, inferior oblique
If the CN III palsy is painful, what is the likely cause?
An aneurysm
What are the causes of CN III palsy?
Microvascular, trauma, aneurysm, MS, congenital
What are the causes of internuclear ophthalmoplegia?
MS, vascular, repeated eye strain from reading small print
