Archives for January 2020

Neuro-ophthalmology Illustrated Chapter 13 Diplopia 10 – Convergence, Divergence & Ocular Motor Apraxia

Questions:
125. What is congenital ocular motor apraxia?
126. What is convergence spasm?
127. What is the cause of convergence spasm?
128. What test will usually differentiate convergence spasm from a bilateral 6th nerve palsy?
129. What is convergence insufficiency?
130. How is convergence insufficiency treated?
131. What are causes of convergence insufficiency?
132. What is divergence insufficiency?
133. What causes divergence insufficiency?
134. What lesion location is likely in the presence of horizontal conjugate deviation of the eyes to one side?

Neuro-ophthalmology Illustrated Chapter 13 Diplopia 9 – Internuclear & Supranuclear Lesions

Questions:
115. A patient has a deficit of adduction of the one eye, nystagmus of the fellow abducting eye, skew deviation and the adduction deficit is overcome with convergence. What condition is present?
116. A patient has a deficit of adduction of the one eye, nystagmus of the fellow abducting eye, skew deviation and the adduction deficit is overcome with convergence. Where is the lesion?
117. What are 4 findings of a unilateral internuclear ophthalmoplegia?
118. A patient has a deficit of adduction of both eyes, nystagmus of the fellow abducting eye, exotropia, and loss of convergence. What condition is present?
119. Where is the lesion located in wall-eyed bilateral internuclear ophthalmoplegia (WEBINO)?
120. A patient has the following findings: a gaze palsy to one side, and on attempted gaze to the opposite side impaired adduction and nystagmus of the abducting eye. In addition, the patient has a facial palsy on the side with the gaze palsy. What syndrome is present?
121. Where is the lesion in the One-and-a-Half Syndrome?
122. What are 2 common causes of isolated internuclear ophthalmoplegia?
123. What conditions may mimic an isolated internuclear ophthalmoplegia?
124. What conditions may mimic the one-and-a-half syndrome?

Neuro-ophthalmology Illustrated Chapter 13 Diplopia 8 – Miller Fisher, Guillain-Barré & Botulism

Questions:
104. What diagnoses should be considered in all cases of new-onset constant or transient ptosis and/or diplopia?
105. What syndromes have ataxia, areflexia, and ophthalmoplegia?
106. What is the Miller Fisher syndrome?
107. What is the Guillain-Barré syndrome?
108. What is the difference between the Miller Fisher and the Guillain-Barré syndromes?
109. When should the Wernicke encephalopathy be considered?
110. What is Wernicke encephalopathy?
111. What does botulism do to the pupils and what are its other symptoms?
112. What is the infectious agent of botulism?
113. What is the mechanism of botulism toxin?
114. What is the treatment for botulism?

Neuro-ophthalmology Illustrated Chapter 13 Diplopia 7 – Lesion Involves Multiple Cranial Nerves

Questions:
92. What signs when associated with lesions causing unilateral or bilateral ophthalmoplegia may help localize the lesion?
93. What are the findings of the orbital apex syndrome?
94. Do brainstem lesions often produce multiple cranial nerve palsies?
95. What are 4 systemic disorders that affect the cranial nerves?
96. What condition should be considered in patients with unilateral or bilateral ophthalmoplegia and normal pupils presumed to result from multiple cranial neuropathies?
97. What is the likely cause of a painful orbital apex syndrome in a diabetic patient?
98. Do normal orbital imaging studies rule out an orbital apex lesion?
99. Does the orbital apex syndrome involve the second division of the fifth nerve?
100. What are the findings of the cavernous sinus syndrome?
101. If a cavernous sinus syndrome includes venous hypertension (carotid-cavernous fistula or cavernous sinus thrombosis), what additional findings may be present?
102. Which cranial nerves are enclosed in the lateral wall of the cavernous sinus?
103. Why do cavernous carotid artery aneurysms often present with an isolated sixth nerve palsy?