Cranial Nerve Palsies in Children and Young Adults
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Questions and Answers

What is the common treatment for acute paralytic strabismus due to unilateral sixth nerve palsy?

  • Eye muscle surgery
  • Prescribing glasses
  • Botulinum neurotoxin (correct)
  • Ordering an MRI or CT scan
  • What is the first step in managing strabismic symptoms?

  • Prescribing glasses (correct)
  • Ordering an angiography
  • Eye muscle surgery
  • Occlusion
  • What is the preferred type of prism for long-term treatment of diplopia?

  • Ground-in Prism (correct)
  • Botulinum neurotoxin
  • Monocular occlusion
  • Fresnel press-on prisms
  • What is a common short-term treatment for diplopia?

    <p>Botulinum neurotoxin</p> Signup and view all the answers

    What may be necessary after eye muscle surgery for long-term treatment of strabismus?

    <p>Prescribing glasses</p> Signup and view all the answers

    What is a potential risk following strabismus surgery?

    <p>Ocular ischemia</p> Signup and view all the answers

    What is the typical dosage range for Botulinum neurotoxin into a muscle?

    <p>2 to 4 units</p> Signup and view all the answers

    What is the purpose of monocular occlusion as a short-term treatment for diplopia?

    <p>To improve visual acuity</p> Signup and view all the answers

    Which cranial nerve innervates the superior rectus, medial rectus, inferior rectus, and inferior oblique muscles?

    <p>CN III</p> Signup and view all the answers

    What is the most common cause of cranial nerve 3 palsy in adults?

    <p>Diabetes</p> Signup and view all the answers

    Which type of strabismus is associated with abnormal visual development?

    <p>Congenital</p> Signup and view all the answers

    What are the symptoms of cranial nerve paralysis?

    <p>Double vision, blurry vision, reduced peripheral vision, headaches</p> Signup and view all the answers

    Which cranial nerve is responsible for eye movement and pupil constriction?

    <p>CN III</p> Signup and view all the answers

    What type of strabismus may be associated with head tilt?

    <p>Neurological onset</p> Signup and view all the answers

    Which condition can cause raised intracranial pressure leading to cranial nerve 3 palsy?

    <p>Hydrocephalus</p> Signup and view all the answers

    What type of tumors or malformations can cause cranial nerve 3 palsy?

    <p>Posterior fossa tumors or malformations</p> Signup and view all the answers

    Which cranial nerve palsy can result in ipsilateral pre-ganglionic Horner’s syndrome and contralateral superior oblique palsy?

    <p>Cranial nerve 4 palsy</p> Signup and view all the answers

    What is the common cause of cranial nerve 6 palsy?

    <p>Inflammatory meningitis</p> Signup and view all the answers

    Which muscle palsies affect the superior rectus and inferior oblique of the same eye?

    <p>Double elevator palsy</p> Signup and view all the answers

    What is the purpose of the forced duction test?

    <p>To diagnose mechanical restrictions or paretic muscles in eye movement</p> Signup and view all the answers

    Which type of neurogenic palsies cause gaze palsies and tonic gaze deviation?

    <p>Supranuclear lesions</p> Signup and view all the answers

    What does double depressor palsy affect?

    <p>Inferior rectus and superior oblique of the same eye</p> Signup and view all the answers

    What is the management for infranuclear neurogenic palsies affecting CN III, IV, and VI?

    <p>Detailed case history and appropriate medical history</p> Signup and view all the answers

    What is the main cause of multiple cranial nerve palsies?

    <p>Neoplasms</p> Signup and view all the answers

    Which test is used to diagnose mechanical restrictions or paretic muscles in eye movement?

    <p>Forced duction test</p> Signup and view all the answers

    What is the differential diagnosis for muscle palsies like Duane’s retraction syndrome?

    <p>Myasthenia gravis</p> Signup and view all the answers

    Which cranial nerve palsy affects the lateral rectus?

    <p>Cranial nerve 6 palsy</p> Signup and view all the answers

    What is the presentation of cranial nerve 6 palsy?

    <p>Lateral diplopia and convergent strabismus</p> Signup and view all the answers

    Study Notes

    Cranial Nerve Palsies in Children and Young Adults

    • Cranial nerve 3, 4, and 6 palsy tests include cover tests, pupil testing, and Hess-Lancaster test.
    • Cranial nerve 4 palsy affects the superior oblique and can be caused by congenital abnormal development or head trauma.
    • Cranial nerve 4 palsy can result in ipsilateral pre-ganglionic Horner’s syndrome and contralateral superior oblique palsy.
    • Cranial nerve 6 palsy affects the lateral rectus and can be caused by trauma, aneurysm, or inflammatory meningitis.
    • Cranial nerve 6 palsy presentation includes lateral diplopia and convergent strabismus, with lateral rectus being more susceptible to ischemia.
    • Multiple cranial nerve palsies can affect CN 3, 4, 5, 6, or Horner’s syndrome, with neoplasms and inflammation being common causes.
    • Other forms of paralysis include muscle palsies like Duane’s retraction syndrome, and differential diagnosis includes myasthenia gravis and thyroid eye disease.
    • Double elevator palsy affects the superior rectus and inferior oblique of the same eye, resulting in no elevation in abduction or adduction.
    • Forced duction test is used to diagnose mechanical restrictions or paretic muscles in eye movement.
    • Double depressor palsy affects the inferior rectus and superior oblique of the same eye, leading to no depression in abduction or adduction, with head tilting down as a compensation.
    • Neurogenic palsies are categorized into supranuclear, internuclear, and infranuclear, with supranuclear lesions causing gaze palsies and tonic gaze deviation.
    • Infranuclear neurogenic palsies affect CN III, IV, and VI, and the management includes detailed case history and appropriate medical history.

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    Description

    Test your knowledge of cranial nerve palsies in children and young adults with this quiz. Explore topics such as cranial nerve 3, 4, and 6 palsy tests, presentations, causes, and differential diagnoses. Dive into the details of muscle palsies, forced duction tests, and the categorization of neurogenic palsies.

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