What cranial nerves have special senses?
I, II, VII, IX, VII
What cranial nerves supply ordinary senses?
V, VII, X
What cranial nerves supply motor activity?
III, IV, VI, V, VII, X, XI
What cranial nerves have autonomic functions?
III, VII, IX, X
What would bilateral CN III signs signify?
Midbrain issue
What would III, IV and VI signs signify?
Problems with superior orbital fissure
What would VI and VII signs signify?
Pons issue
What would V and VII signs signify?
Cerebellopontine angle issue
Where can the cranial nerves be damaged?
Within the brain
Crossing the subarachnoid space
Outside the skull
How can the cranial nerves be damaged within the brain?
Ischaemia
Tumour
How can cranial nerves be damaged crossing the subarachnoid space?
By meningitis
How can cranial nerves be damaged outside the skull?
By base of skull tumours
What causes optic neuritis?
Demyelination of optic nerve
What are the symptoms of optic neuritis?
Pain on eye movement
Reduced visual acuity
Reduced colour vision
What is optic neuritis associated with?
Often associated with MS
What are the causes of dilated pupils?
Youth Dim lighting Anxiety, excitement Mydriatic eye drops Amphetamine, cocaine CN III palsy Brain death
What are the causes of small pupils?
Old age Bright light Miotic eye drops Opiate overdose Horner's syndrome
What are the eye movement disorders?
Isolated third nerve palsy Isolated fourth nerve palsy Isolated sixth nerve palsy Supranucleus nerve palsy Nystagmus Combination nerve palsy
What are the types of isolated third nerve palsy?
Microvascular
Compressive
What are the features and causes of microvascular third nerve palsy?
Painless eye movement disorder, pupil spared
Causes- diabetes, hypertension
What are the features and causes of compressive third nerve palsy?
Painful eye movement disorder, pupil involved
Causes- posterior communicating artery aneurysm, raised something??
What are the cases of a sixth nerve palsy?
Idiopathic
Diabetes
Meningitis
Raised ICP
What are the causes of nystagmus?
Congenital Serious visual impairment Peripheral vestibular problem Central vestibular/brainstem disease Cerebellar disease Toxins
What is trigeminal neuralgia?
Paroxysmal attacks of lancinating ain
What causes trigeminal neuralgia?
Compression of CN V in posterior fossa
What is the treatment of trigeminal neuralgia?
Carbamazepine
Surgery if resistant
What is Bell’s palsy?
Unilateral facial weakness
LMN type
What are the features of Bell’s palsy?
Often preceded by pain behind ear
Eye closure affected
Risk of corneal damage
What is the treatment of Bell’s palsy?
Steroids
What are the 2 types of facial paralysis?
Upper motor neuron
Lower motor neuron
What are the causes of upper motor neurone facial paralysis?
Stroke
Tumour
What are the causes of lower motor neurone facial paralysis?
Bell’s palsy
Lyme’s disease
Sarcoid
What are the symptoms of vestibular neuritis?
Disabling vertigo
Vomiting
What ae the features of vestibular neuritis?
Sudden onset
Gradual recovery
Cause unknown
What is dysarthria?
Disordered articulation, slurred speech
What is dysphagia?
Difficulty swallowing
What is a bulbar palsy?
Bilateral LMN lesions affecting IX-XII
What are the symptoms of a bulbar palsy?
Wasted, fasciculaing tongue
Dysarthria
Dysphonia
Dysphagia
What are some bulbar palsies?
Motor neuron diseaase Polio Tumours Vascular lesions of medulla Syphillis
What is a pseudo bulbar palsy?
Bilateral upper motor neuron palsy
What are the symptoms of a pseudo bulbar palsy?
Dysarthria Dysphonia Dysphagia Spastic, immobile tongue Brisk jaw jerk Brisk gag reflex
What are the causes of a pseudo bulbar palsy?
Vascular lesions in both internal capsules
Motor neuron disease