CRANIAL NERVES

EXAMINATION
Dr kauser mahmood
BRAIN STEM
CRANIAL NERVES AND PARTS OF
BRAINN STEM
 Causes of olfactory nerve lesion
 diseases of the nose and paranasal sinuses,
recent upper respiratory tract infection
 head trauma
Olfactory bulb on MRI Brain
OPTIC PATHWAY
OPTIC PATHWAY
Optic pathway
Causes of optic nervepalsy
 Causes of optic chiasma
 pituitary adenomas
 Craniopharyngiomas
 Multiple sclerosis
 Glioma
Optic chiasma compression by pituitary
tumor
Muscles of eye movement
Direction of eye muscles movement
 levator palpebrae superioris
 The levator palpebrae
superioris (Latin: eleva
ting muscle of upper
eyelid) is
the muscle that
elevates the
upper eyelid.
Parasympathetic pathway
3RD NERVE PALSY
 Causes of ptosis
 occulomotor nerve palsy-----with dilated pupil
 Horner's syndrome-------with constricted pupil
 myasthenia gravis------pupil normal
3RD NERVE PALSY
CAUSES OF 3RD NERVE PALSY

migraine
brain tumor
aneurysm
diabetes
high blood pressure.
4TH NERVE PALSY
 vertical diplopia
(worse on downgaze).
The patient especially
notices diplopia when
coming down the
stairs
Right abducent nerve palsy
 Causes of 6th nerve palsy
 Injury (especially if a skull fracture is present)
 Stroke.
 Infection (for instance, from Lyme disease or
from a virus)
 Brain tumor.
 Inflammation of the nerve, for instance, after a
vaccine.
 Multiple sclerosis.
 Elevated pressure inside the brain (for instance,
from meningitis)
 5TH NERVE (TRIGEMIENAL
NERVE)PALSY
SENSORY SUPPLY
MOTOR SUPPLY
 The motor component of the
trigeminal nerve controls the
movement of eight muscles
four muscles of mastication
 the masseter
 the temporal muscle
 the medial pterygoides
 lateral pterygoids
 tensor veli palatini
 mylohyoid
 the anterior belly of the digastric
 tensor tympani.
 Causes of trigeminal nerve
 trauma
 local anaesthesi
 , tumour removal
 implant placement
Muscles supplied by facial nerve
Upper UMN vs LMN
Facial nerve palsy
UMN VS LMN type facial palsy
Facial nerve palsy
Bells palsy
 herpes simplex
 sarcoidosis
 diabetes
 Lyme disease
 TREATMENT OF Bells palsy
 Prednisone is typically prescribed in a 10-day
tapering course starting at 60 mg per day.

 Because of the possible role of HSV-1 in the

etiology of Bell's palsy, the antiviral drugs acy-
clovir (Zovirax) and valacyclovir (Valtrex) have
been studied to determine if they have any
benefit in treatment.

 acyclovir 400 mg can be given five times per day

for seven days
RAMSY HUNT SYNDROME
Cerebellopontine angle
Cerebellopontine angle
Lesions in the area of
cerebellopontine angle
cause signs and symptoms
secondary to compression
of nearby cranial nerves
including cranial nerve
V(trigeminal), cranial
nerve VI(abducent),
cranial nerve VII (facial),
and cranial nerve VIII
(vestibulocochlear).
causes include acoustic
neuroma and meningioma