Abducens Nerve Palsy and Esotropia

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Which nerve is responsible for controlling the lateral rectus muscle that abducts the eye?

Trochlear (fourth cranial) nerve
Abducens (sixth cranial) nerve (correct)
Oculomotor (third cranial) nerve
Trigeminal (fifth cranial) nerve

What is the most common ocular motor paralysis in adults?

Trochlear (fourth cranial) nerve palsy
Trigeminal (fifth cranial) nerve palsy
Abducens (sixth cranial) nerve palsy (correct)
Oculomotor (third cranial) nerve palsy

What is the result of an abducens nerve palsy?

Exotropia
Hyperopia
Esotropia (correct)
Myopia

Where does the abducens nerve travel through before entering the orbit?

Cavernous sinus and superior orbital fissure (A) Signup and view all the answers

What is a risk factor for abducens nerve palsy in adults?

Hypertension (C) Signup and view all the answers

What is the significance of a sudden onset of abducens nerve palsy?

It suggests a vascular etiology (D) Signup and view all the answers

What is the anatomical location where the abducens nerve is tethered?

Dorello’s canal (C) Signup and view all the answers

What is the location of the nucleus of the abducens nerve?

Pons (B) Signup and view all the answers

What is the most common diagnostic procedure for abducens nerve palsy?

Magnetic Resonance Imaging (MRI) with gadolinium and fat suppression (C) Signup and view all the answers

In which patients is MRI recommended?

All patients under the age of 50 years, those that present with non-isolated abducens nerve palsy, have a history of cancer, or have an absence of microvascular risk factors (A) Signup and view all the answers

How is diplopia in myasthenia gravis characterized?

Fluctuating and fatigable (C) Signup and view all the answers

What is the primary treatment for underlying or systemic conditions in abducens nerve palsy?

Treating the underlying condition (B) Signup and view all the answers

How long do most patients with microvascular abducens nerve palsy recover?

3-6 months (A) Signup and view all the answers

What is the purpose of botulinum toxin injections in abducens nerve palsy?

To weaken the medial rectus (C) Signup and view all the answers

When is surgical intervention usually reserved for?

After 6 months of stable orthoptic measurements (A) Signup and view all the answers

What is the most likely complication following surgical correction of abducens nerve palsy?

Over- or under-correction (B) Signup and view all the answers

What determines the prognosis for abducens nerve palsy?

Underlying etiology (A) Signup and view all the answers

What suggests a demyelinating process?

Subacute onset (A) Signup and view all the answers

What is the most common presenting symptom of abducens nerve palsy?

Diplopia (A) Signup and view all the answers

What is the cardinal sign of abducens nerve palsy?

Esotropia of the affected eye (D) Signup and view all the answers

What is the location of the lesion in Millard-Gubler syndrome?

Brainstem (B) Signup and view all the answers

What is the purpose of cycloplegic refraction in the evaluation of abducens nerve palsy?

To assess the refractive error of the patient (A) Signup and view all the answers

Why is it important to test each eye independently in the evaluation of abducens nerve palsy?

To avoid pseudo-restrictive effects of alternating monocular fixation and vergence (C) Signup and view all the answers

What is the characteristic of esotropia in abducens nerve palsy?

It is incomitant and greater at distance (C) Signup and view all the answers

What is the usual method of diagnosis of abducens nerve palsy?

Clinical examination (B) Signup and view all the answers

What is the characteristic of diplopia in abducens nerve palsy?

Horizontal and uncrossed (A) Signup and view all the answers

What is the significance of slow saccadic velocity in side gaze?

It is a diagnostic feature of abducens nerve palsy (B) Signup and view all the answers

What is the primary reason why the affected eye turns medially in abducens nerve palsy?

Due to the unopposed action of the medial rectus muscle (A) Signup and view all the answers

Where does the abducens nerve begin its course?

In the dorsal pons (B) Signup and view all the answers

What is the significance of a slowly progressive onset of abducens nerve palsy?

It suggests a compressive etiology (B) Signup and view all the answers

What is the characteristic of esotropia in abducens nerve palsy?

It is incomitant and greater at near than at distance (B) Signup and view all the answers

What is the anatomic location where the abducens nerve is tethered?

In Dorello's canal (B) Signup and view all the answers

What is the most common presenting symptom of abducens nerve palsy in children?

Diplopia (A) Signup and view all the answers

What is the risk factor for abducens nerve palsy in adults?

All of the above (D) Signup and view all the answers

What is the characteristic of the abducens nerve course?

It has the longest intracranial course (B) Signup and view all the answers

What is the most common underlying etiology of abducens nerve palsy in children?

Neoplasm (A), Trauma (D) Signup and view all the answers

What is the significance of palpebral fissure widening upon abduction effort in abducens nerve palsy?

It is a sign of attempted abduction (C) Signup and view all the answers

What is the characteristic of esotropia in abducens nerve palsy?

It is greater at distance than at near (B) Signup and view all the answers

What is the significance of slow saccadic velocity in side gaze in abducens nerve palsy?

It is a diagnostic feature of abducens nerve palsy (C) Signup and view all the answers

What is the purpose of measuring fusional amplitudes in the evaluation of abducens nerve palsy?

To assess the quality of binocular vision (A) Signup and view all the answers

What is the characteristic of diplopia in abducens nerve palsy?

It is horizontal and uncrossed (A) Signup and view all the answers

What is the significance of a head turn toward the affected eye in abducens nerve palsy?

It is a compensatory mechanism to avoid diplopia (B) Signup and view all the answers

What is the significance of raised intracranial pressure in abducens nerve palsy?

It is a symptom of headache and pain around the eyes (C) Signup and view all the answers

What is the characteristic of the deviation in abducens nerve palsy?

It is greater at distance than at near (B) Signup and view all the answers

What is the importance of evaluating ductions and versions in the diagnosis of abducens nerve palsy?

It is helpful in determining incomitance (C) Signup and view all the answers

What is the primary purpose of MRI in the diagnosis of abducens nerve palsy?

To rule out underlying etiologies (D) Signup and view all the answers

Which of the following conditions may present with unilateral symptoms including proptosis and inflammation?

Thyroid eye disease (D) Signup and view all the answers

What is the significance of a 6-month period in the management of abducens nerve palsy?

The time required for orthoptic measurements to stabilize (B) Signup and view all the answers

What is the purpose of forced duction test in the management of abducens nerve palsy?

To assist with surgical planning (A) Signup and view all the answers

What is the most common complication following surgical correction of abducens nerve palsy?

Over- or under-correction (D) Signup and view all the answers

What is the significance of the presence of microvascular risk factors in patients with abducens nerve palsy?

It may affect the decision to perform MRI (D) Signup and view all the answers

What is the purpose of occlusion using a Bangerter filter or patch in the management of abducens nerve palsy?

To eliminate diplopia and confusion (D) Signup and view all the answers

What is the characteristic of diplopia in patients with myasthenia gravis?

It is fluctuating and fatigable (A) Signup and view all the answers

In which patients may the diagnostic yield of MRI be relatively low?

Elderly patients with isolated abducens nerve palsy and vasculopathic risk factors (D) Signup and view all the answers

What is the primary goal of treatment for underlying or systemic conditions in patients with abducens nerve palsy?

To treat the underlying condition (C) Signup and view all the answers

Abducens Nerve Palsy and Esotropia

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Questions and Answers

Which nerve is responsible for controlling the lateral rectus muscle that abducts the eye?

What is the most common ocular motor paralysis in adults?

What is the result of an abducens nerve palsy?

Where does the abducens nerve travel through before entering the orbit?

What is a risk factor for abducens nerve palsy in adults?

What is the significance of a sudden onset of abducens nerve palsy?

What is the anatomical location where the abducens nerve is tethered?

What is the location of the nucleus of the abducens nerve?

What is the most common diagnostic procedure for abducens nerve palsy?

In which patients is MRI recommended?

How is diplopia in myasthenia gravis characterized?

What is the primary treatment for underlying or systemic conditions in abducens nerve palsy?

How long do most patients with microvascular abducens nerve palsy recover?

What is the purpose of botulinum toxin injections in abducens nerve palsy?

When is surgical intervention usually reserved for?

What is the most likely complication following surgical correction of abducens nerve palsy?

What determines the prognosis for abducens nerve palsy?

What suggests a demyelinating process?

What is the most common presenting symptom of abducens nerve palsy?

What is the cardinal sign of abducens nerve palsy?

What is the location of the lesion in Millard-Gubler syndrome?

What is the purpose of cycloplegic refraction in the evaluation of abducens nerve palsy?

Why is it important to test each eye independently in the evaluation of abducens nerve palsy?

What is the characteristic of esotropia in abducens nerve palsy?

What is the usual method of diagnosis of abducens nerve palsy?

What is the characteristic of diplopia in abducens nerve palsy?

What is the significance of slow saccadic velocity in side gaze?

What is the primary reason why the affected eye turns medially in abducens nerve palsy?

Where does the abducens nerve begin its course?

What is the significance of a slowly progressive onset of abducens nerve palsy?

What is the characteristic of esotropia in abducens nerve palsy?

What is the anatomic location where the abducens nerve is tethered?

What is the most common presenting symptom of abducens nerve palsy in children?

What is the risk factor for abducens nerve palsy in adults?

What is the characteristic of the abducens nerve course?

What is the most common underlying etiology of abducens nerve palsy in children?

What is the significance of palpebral fissure widening upon abduction effort in abducens nerve palsy?

What is the characteristic of esotropia in abducens nerve palsy?

What is the significance of slow saccadic velocity in side gaze in abducens nerve palsy?

What is the purpose of measuring fusional amplitudes in the evaluation of abducens nerve palsy?

What is the characteristic of diplopia in abducens nerve palsy?

What is the significance of a head turn toward the affected eye in abducens nerve palsy?

What is the significance of raised intracranial pressure in abducens nerve palsy?

What is the characteristic of the deviation in abducens nerve palsy?

What is the importance of evaluating ductions and versions in the diagnosis of abducens nerve palsy?

What is the primary purpose of MRI in the diagnosis of abducens nerve palsy?

Which of the following conditions may present with unilateral symptoms including proptosis and inflammation?

What is the significance of a 6-month period in the management of abducens nerve palsy?

What is the purpose of forced duction test in the management of abducens nerve palsy?

What is the most common complication following surgical correction of abducens nerve palsy?

What is the significance of the presence of microvascular risk factors in patients with abducens nerve palsy?

What is the purpose of occlusion using a Bangerter filter or patch in the management of abducens nerve palsy?

What is the characteristic of diplopia in patients with myasthenia gravis?

In which patients may the diagnostic yield of MRI be relatively low?

What is the primary goal of treatment for underlying or systemic conditions in patients with abducens nerve palsy?

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