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Neuroanatomy - Crainal Nerve Pathololgies


Q. A 65 y/o man was in a meeting when suddenly he lost control of the right side of his body, including his face. He slumped in his chair and the right side of his face appeared to sag and he complained of double vision. He did not lose consciousness. Somatosensation is intact. Movement and strength on the left side of his body are normal. He is able to sit assisted in a chair with arm and back support. (a) He is able to voluntarily move his right upper limb at the shoulder and his right lower limb at the hip but strength is less than half on the left side. He cannot move any other joints in his limbs on the right.

All cranal nerves are intact except for:

(a) Where is the lesion? (area of CNS and side)
(b) He is unable to voluntarily move his right lower face.
(c) He cannot move his left eye medially, downward or upward.
(d) He cannot fully open his left eye.
(e) The left eye pupil is dilated and does not contract in response to light shined into the eye.

These are the answers I have come up with, could you please check them?

(a) Lesion is " Left Corticospinal tract"
(b) Facial nerve - buccinators
(c) Abducens nucleus (medial strabismis)
(d) Trochlear
(e) Occulomotor nerve

By OTA:  Elisabeth Nicholson, PhD (IP)

OTA Rating:  4.9/5

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