Cranial nerve disorders Flashcards by Hannah Maclean

nerves in relation to eyes?

3,4,6,

How well did you know this?

Not at all

Perfectly

SO muscle of the eye, innervated by what nerve?

CNIV - trochlear

in an ddownward movement

How well did you know this?

Not at all

Perfectly

LR muscle of the eye, innervated by what nerve?

CNVI - abducens

lateral movement

How well did you know this?

Not at all

Perfectly

double vision looking down indicates what?

CNIV - trochlear

4th nerve palsy following head injury

How well did you know this?

Not at all

Perfectly

causes IVth nerve palsy?

congenital

idiopathic

severe head trauma

microvascular disease (HT, DM, atherosclerosis)

tumour

aneurysm

How well did you know this?

Not at all

Perfectly

MS?

CNS, white matter demyelination disorder

How well did you know this?

Not at all

Perfectly

4th nerve ipsilateral of contralateral?

condralateral

How well did you know this?

Not at all

Perfectly

ptosis?

drooping eyelid

How well did you know this?

Not at all

Perfectly

dilated pupil/occulomotor abnormalities, what nerve is affected?

3rd nerve palsy

eye down and out, complete ptsosis and dilated pupil

How well did you know this?

Not at all

Perfectly

causes of 3rd nerve palsy?

microvascular, infact of teh centre of the 3rd nerve
- can be pupil sparing

posterior aneurysm
- pupil involving, pt about to rupture an aneurysm

cavernous sinus
- tumour
- sinus thrombosis

meningeal
- aneurysm (posterior commuivcatung artery aneurysm)
- infective or malignant meningitus/inflammation

neuromuscular junction - myasthenia

How well did you know this?

Not at all

Perfectly

what nerve innervates the levator palpabre superioris?

occulomotor CN3

How well did you know this?

Not at all

Perfectly

syndrome associated with CN3 palsy?

horner’s syndrome

How well did you know this?

Not at all

Perfectly

symtoms of horner’s syndrome?

constricted pupil

small ptsosis, couple milimetreds drop in eyelid. droopy eyelid

How well did you know this?

Not at all

Perfectly

fatuigable CN3 palsy?

myasthenia gravis

How well did you know this?

Not at all

Perfectly

sympatheuc muller’s muscle? (CNIII)

muscle helps rasie the upper eyelid

How well did you know this?

Not at all

Perfectly

myasthenia gravis? (CNIII)

Myasthenia gravis is a rare long-term condition that causes muscle weakness.

autoimmune disorder, antibodies against acetyl nicotinic acetylcholione receptor

It most commonly affects the muscles that control the eyes and eyelids, facial expressions, chewing, swallowing and speaking. But it can affect most parts of the body.

It can affect people of any age, typically starting in women under 40 and men over 60

How well did you know this?

Not at all

Perfectly

causes of horners syndrome? (CNIII)

Injury
- Damage to the carotid artery, the main artery to the brain
Injury to the brachial plexus, the nerves at the base of the neck
Birth trauma, such as during a difficult birth
Accidental injury

Tumors
- Tumors at the top of the lung
Tumors between the lungs and neck
Neuroblastoma, a childhood cancer of the nerve tissues

Other conditions

Migraine or cluster headaches
Stroke
Spinal cord injury
Infection in the top of the lung, between the lungs, and neck
Surgical complications

Congenital or hereditary

Horner syndrome can be present at birth, or it can be inherited

Idiopathic

Sometimes no cause can be found. This is called idiopathic Horner syndrome.

How well did you know this?

Not at all

Perfectly

types of MG?

Study These Flashcards

pure ocular MG

gernalised mg
- Extra-ocular
- bulborespiratory muscles
- limbs

what is associated with MG?

Study These Flashcards

thymoma and thymic hyperplasia

tx for MG?

Study These Flashcards

acetylcholineesterase inhibitirs (used to wake up form GA)

immunosuppression
- steroids
- IV immunoglobulin, plasma exchange
- Azathioprine, cyclosporin, cyclophosphamide, methotrexate

examples of acetylychonesterase inhibitirs?

Study These Flashcards

pyridostigimine, neostigmine

casues of worsening MG?

Study These Flashcards

Infection
– Drugs, aminoglycosides, quinolones, quinine

32 year-old 2/7 pain behind ear
Awoke right facial paralysis –near complete
Noises sound louder on RHS

what is the problem?

Study These Flashcards

bells pasly

who is most at risk of bells palsy?

Study These Flashcards

More common age 30-45
– 5-fold in diabetes
– 3-fold in pregnancy esp. 3rd trimester

prognosis of bells pasly?

90% had complete recovery – 60% with complete paralysis had complete recovery – 85% begin to recover by 3 weeks – 15% permanently diminished weakness or synkinesis – 8-10% have recurrence- ipsi or contralateral

causes of bells pasly?

lime disease viral infection meningitus ...

symptoms of bells palsy?

Drooping of the eyelid and corner of the mouth Difficulty closing one eye Difficulty eating and drinking Drooling Facial pain Dry mouth Changes in taste Eye pain Excessive tearing (crocodile tears)

Differential diagnosis of unilateral facial pasly?

* Idiopathic (Bell’s palsy) * Pontine tumour (e.g. acoustic neuroma), demyelination, stroke * Infective – Varicella zoster – Ramsay Hunt syndrome – Lyme disease – Middle ear infections * Ischaemia – Vasculitis * Inflammation – Sarcoid – Sjogren’s syndrome – Behcet’s * Temporal bone fracture or tumour * Parotid gland tumours/infections * Facial trauma * Upper motor neuron facial weakness

UMN lesion causes?

stroke or tumour lower half of face completely paralysed, can wrinkle forehead

LMN lesion causes?

bells palsy, lyne, sarcoid opposute side completely paralysed

tx for bells pasly?

steroid for 10 days - within 3 days of onset - prednisolone 50 mg daily eye protection - artifiial tears - cover eye at night

triggers of trigeminal neuralgia?

brushing teeth, eating, wind of face, talking

common cause of trigeminal neuralgia?

commonly root entry zone irrtation by artery other causes: tumour, MS

tx for trigeminal neuralgia?

* good response to Carbamazepine, gabapentin, amitryptylline * Surgery – decompress artery, foramen ovale injections

symptoms of trigeminal neuralgia?

- Sudden, sharp, stabbing pain in the face - Pain that lasts from seconds to minutes - Pain that usually affects one side of the face - Aching, burning, or throbbing sensation between attacks - Pain that can be triggered by touch, sounds, or vibrations

CNXII palsy?

* Exits hypoglossal canal * Close proximity to accessory+vagus N. and internal carotid artery * Tongue deviates to side of lesion + fasciculations + wasting

causes of CNXII palsy?

– Trauma (12%) – Stroke (6%) – Multiple Sclerosis (6%) – Surgery (5%) – Guillain Barre Syndrome (4%)

nerves that control speech, chewing and swallowing?

CN V (motor) * CN VII, IX, X, XI, XII

cerebeller speech?

– staccato speech +nystagmus +balance impairment +incoordination

bulbar palsy (LMN)?

– flaccid nasal dysarthria – nasal regurgitation

pseudobulbar palsy (bilateral UMN)

– spastic dysarthria – emotional lability – droolin

Causes of speech and swallowing disorders?

* Cerebellar disorders – Stroke – multiple sclerosis – hereditary ataxia – drugs (e.g. carbemazepine) - tumour * Bulbar palsy – Neuropathy – Myasthenia – Myopathy – Motor neuron disease * Pseudobulbar palsy (R+L corticobulbar UMN lesions) – MS – MND – Bilateral strokes

Guillain-Barré syndrome (GBS) ?

Guillain-Barré syndrome (GBS) is a rare neurological disorder that occurs when the body's immune system attacks the peripheral nervous system. This damage can cause muscle weakness and sometimes paralysis. Symptoms - Weakness or tingling in the legs, arms, face, or upper body - Difficulty swallowing or breathing - Loss of sensation in the arms or legs - Fatigue - Anxiety and depression Causes - Infection with a virus or bacteria, such as campylobacter, influenza, or COVID-19 - Surgery or trauma

Cranial nerve disorders Flashcards

(43 cards)