Nerve

Oculomotor nerve III

Innervate 1-Superior, Medial, Inferior Rectus, Inferior Oblique 2- Visceral Motor: Sphincter Pupillae

Lesion Pupil asymmetry -No pupil reflex, dilated pupil - Drooping of eyelid - Double vision, - Difficulty focusing - Inability to move eye in certain directions

Causes Horners Syndrome: Major causes of CNS disease, Ptosis ,Miosis Intraorbital structural lesions Anhydrosis ,Enopthalmos Posterior communicating artery aneurysms Investigation: Orbital trauma, Inflamed orbit A thorough neurologic examination , CT or MRI Myopathies Lumbar puncture for suspected subarachnoid hemorrhage . Cerebral angiography if aneurysm suspected Many are idiopathic. Closed head trauma without skull fracture , Aneurysms, tumors, Treatment : Oculomotor exercises may help. Sometimes surgery is necessary to restore concordant vision. treatment may require cutting nerve three major branches : ophthalmic maxillary mandibular

Trochlear Nerve IV

superior oblique muscle

Damage causes double vision and inability to rotate eye infero-laterally

General somatic afferent Principal sensory nerve for head, face, orbit and oral cavity Mediate sensations of pain, temperature, proprioception and fine touch Sensations from anterior 2/3 of tongue mastication muscles Lateral Rectus Muscle

Trigeminal neuralgia : neoplasm, vascular malformation Recurring episodes of intense stabbing pain in trigeminal nerve multiple sclerosis, Post-herpetic pain area (near mouth or nose Trigeminal neuropathy in seconds and 2 min, along the distribution of one or more of its Sjgren's syndrome or RA sensory divisions, most often the ,Migraine maxillary. pain triggered by touch, drinking, washing face

Trigeminal V

Diplopia Disappears on Eye Movement to the Right Lateral rectus Lateral gaze Diplopia on abduction Move head to compensate

Diabetic infarction is a common causes. Compression in the cavernous sinus by a tumor Trauma Infections of the meninges, Aneurysm, Multiple sclerosis.

Abducens VI