Cranial nerve palsies

Question 1

What are the signs of an Oculomotor nerve (CNII) palsy

Answer 1

Down and out in the effected eye, ptosis and loss of pupillary reflex (pupil will look dilated). Diplopia.

Question 2

What are the signs of a Trochlear nerve (CNVI) palsy

Answer 2

Patient will tilt their head away from the lesion to counteract diplopia. Affected eye moves up when trying to look at the nose.

Question 3

What are the signs of a Abducens nerve (CNVI) palsy

Answer 3

Patient is unable to abduct the affected eye (look laterally). Therefore the patient may look slightly cross-eyed.

Question 4

Which nerves are involved in a Bulbar palsy

Answer 4

Vagus (X) accessory (XI) and hypoglossal (XII)

Question 5

What are the signs of a Bulbar palsy

Answer 5

Reduced gag reflex, fasculation and muscle wasting in the tongue, normal jaw jerk, raspy voice (unilateral) or Altered phonation - nasal (bilateral), impaired ability to swallow

Question 6

What nerves are involved in a pseudobulbar palsy

Answer 6

Trigeminal (V), Facial (VII) Vagus (X) accessory (XI) and hypoglossal (XII)

Question 7

What are the signs of a pseudobulbar palsy

Answer 7

Increased gag reflex, spasticity in the tongue but NO wasting, increased jaw jerk, spastic dysarthria

Question 8

Is a bulbar palsy an upper or lower motor lesion

Answer 8

Lower motor lesion

Question 9

Is a pseudobulbar palsy an upper or lower motor lesion

Answer 9

Upper motor lesion