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Cranial nerves and Psychiatrist (CN2 (Papiledema (Raised ICT - >…
Cranial nerves and Psychiatrist
CN1
Loss of sense of smell
Oflactory groove meningioma
Age
Local disorders
Olfactory hallucinations
Schiz
epilepsy
Chronic inescapable foul smell
Structural pathology of temporal lobe
get EEG with nasal electrodes and CT Brain
CN2
Actually and extension of the brain tissue
Papiledema
Raised ICT - > swelling of optic disc
when severe also hemorrhages and exudates
Pseudopapiledema
infection, demyleination and congenital disorders
HTR, DR
Chorioretinitis <- toxoplasma infection of brain
bitemporal field cut <- optic chiasm lesion
binasal field cut <- glaucoma
enlarged blind spot <- toxic amblyopia [tobacco, alcohol]
CN3,4,6
Pupillary constriction [3rd nerve]
Prostitute pupil [accomodates but does not respond] Argyll Robertson, Neurosyphilis, DM
Unilateral dilatation in conscious person, PCA aneurysm pressing on 3rd nerve
Direct Reflex weak, Consensual Brisk - > Marcus Gumm, MS
Blown pupil + reduced consciousness -> ICT
Pin Point
Opioid
OP
Pons Hge
EOM
Smooth movement = pursuit
Step like movement = saccades
Most commonly limited eye movement -> upward gaze [age, PSP]
3rd -> down and out
4th -> Head tilt away from the affected eye
6th -> eye in
Nystagmus
esp Horizontal
CN5
Hysterical sensory loss over face
midline fashion
stops at the hairline, but not so if organic
CN7
Facial weakness
disturbed taste
disturbed hearing
UMN - Upper sparing
CN8
Progressive hearing loss or intermittent balance issues
Neurofibroma
Viral infection
CN9,10
Gag reflex, position of Palate and taste sensation
hyperactive gag reflex -> recurrent vomiting
Eating disorders -> induce vomiting but stimulating gag reflex
Raised ICT -> Vomiting
CN11
hysterical weakness pt claim weakness on turning
head towards the side of the weak arm/leg
weakness of SCM and Trapezius -> head tilts and abnormal postures
CN12
Twitching in the tongue may be first sign on
bulbar amyotrophic laternal sclerosis