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DIAGNOSIS. Traumatic right cranial nerve (CN) IV palsy. CLINICAL COURSE. Given the acute, painless onset of the vertical diplopia with a positive Parks-Bielschowsky 3-step test (see "Clinical Features and Evaluation," below) for a right CN IV palsy in the absence of vascular risk factors, negative neuroimaging, and in the setting of recent closed head trauma – the diagnosis of traumatic ...
Left eye: Left cranial nerve VII palsy with weakness of frontalis and orbicularis muscles. Upper eyelid platinum weight in place. There is 5 mm of lagophthalmos with gentle closure and 3 mm with forced closure. Dermatochalasis. Slit lamp exam. Right eye: Rapid tear break up time and mild cataract
Appropriate interventions include control of blood glucose, blood pressure, and lipid levels [2]. While ischemic third nerve palsy can be debilitating to patients, the symptoms fully resolve in 80-85% of patients over a period of three to six months [2, 7, 18, 19]. However, if the condition does not resolve, or the patient desires symptomatic ...
Cranial nerve IV (trochlear nerve) innervates the superior oblique muscle which is responsible for depression and intorsion of the eye. Superior oblique weakness will produce binocular vertical or torsional diplopia that is variable with different gaze directions (many times worse with downgaze). Patients will have a hypertropia of one eye ...
MRI showed nodular enhancement near the pons along the tract of the sixth nerve on the left that is consistent with a schwannoma of cranial nerve VI. Cranial nerve VI (CNVI or abducens nerve) innervates the lateral rectus muscle that is responsible for abduction of the eye. Weakness of the lateral rectus will result in binocular, horizontal ...
In this case the patient had a 5 th cranial nerve palsy causing decreased sensation and was also predisposed to exposure given her 7 th cranial nerve palsy. The differential for etiology of neurotrophic ulcer also includes cerebrovascular accidents, aneurysms, multiple sclerosis, herpes simplex or herpes zoster keratitis, or toxicity with ...
Posted: May 26, 2014. This patient highlights all of the typical features of bilateral 4th nerve palsies, including a V-pattern esotropia, reversing hypertropia on left and right gaze (also with left and right head tilt - not shown), underaction of the superior oblique in depression while adducting, and overaction of the inferior oblique in ...
An isolated fourth nerve palsy is the most common presenting symptom in cases of fourth nerve schwannoma, occurring in about 75% of symptomatic cases. Torun et al. found the average size of fourth nerve schwannomas causing diplopia to be 4.6mm [21]. A more comprehensive review of the clinical features of fourth nerve palsies due to all ...
Cranial Nerve III palsy. The oculomotor nerve innervates the medial rectus, inferior rectus, superior rectus, and inferior oblique muscles. It also innervates the levator palpebrae superioris and carries parasympathetic innervation from the Edinger-Westphal nucleus.
Diagnosis: Infarction of the rostral midbrain and thalamus causing pseudoabducens palsy and vertical gaze palsy. Differential Diagnoses for Bilateral Abduction Deficits. Cranial nerve VI palsy (congenital or acquired) Thalamic infarct; Convergence excess/Spasm of the near reflex