Neuro Exam Flashcards
1
Q
Anisocoria CNIII palsy
A
Causes (INTIMA)
- iatrogenic
- neoplasm
- trauma
- ischaemic (diabetic microvascular, infarct)
- migraine (opthalmoplegic)
- anaeursym (PICA)
Effect
- ptsosis
- pupils
- > no direct or consensual from other eye
- > consensual for other eye intact
- gaze
- > down and out
- movement
- > cannot move in, up or further down
- > diplopia disappears when looking laterally
- motor effects with pupillary sparing
- > not due to aneurysm
- > usually ischaemia
2
Q
CN II palsy
A
Cause
- ischaemic optic neuropathy
- optic neuritis (MS)
- infectious (meningitis)
- post viral
- neoplasia (sellar)
Effects
- decreased visual acuity
- scotoma
- tunnel vision
- afferent pupillary defect
3
Q
Accommodation reflex
A
Isolated deficit
- cortical blindness
- mid brain lesion
Intact with effect pupillary action impaired
- accomodation pathway bypasses pretectal nucleus
- > argyle robertson pupil
- > mid brain lesions
4
Q
Visual field defects
A
Monocular vision loss
-cornea/lens/retina/optic nerve
Bitemporal hemianopia
-optic chiasm
Homonymous hemianopia
-anything proximal to chiasm
Upper quadrantanopia
- lower optic radiation (meyers loop)
- > temporal lobe
Lower quadrantanopia
- upper optic radiatiation
- > parietal lobe
5
Q
CNIV palsy
A
Causes
-rarely isolated
Effect
- cannot look down as far when eye is turned in
- head tilted to opposite shoulder (maintains binocular)
6
Q
CNVI palsy
A
Cause
- raised ICP
- trauma
- tumour
Effect
-affected eye cannot abduct
7
Q
Internuclear ophthalmoplegia
A
Cause
- damaged to MLF
- > usually MS
- > lacunar basilar stroke
Effect
-impaired adduction of affected eye with nystagmus of opposite, adbucted eye
8
Q
CNV palsy
A
Cause
- usually trigeminal neuralgia
- > maxillary +/- mandibular distribution pain
- > sparing of opthalmic
- > compression of CNV against pons
- stroke
Effect
- loss of motor component is rare
- loss of sensation
- loss of corneal reflex for ophthalmic division
9
Q
CNVII palsy
A
Cause
-Bells (most common)
