The nervous system

2018 ◽  
Author(s):  
James Thomas ◽  
Tanya Monaghan
Keyword(s):  
Peripheral Nerves ◽  
Cranial Nerve ◽  
Cranial Nerves ◽  
The Elderly ◽  
The Unconscious ◽  
Applied Anatomy ◽  
Presenting Symptoms ◽  
Primitive Reflexes ◽  
System P ◽  
Cranial Nerve Viii

HistoryPresenting symptomsThe rest of the historyExaminationThe outline examinationGeneral inspection and mental stateCognitive functionSpeech and languageCranial nerve examinationCranial nerves II, III, IV, and VICranial nerve I: olfactoryCranial nerve V: trigeminalCranial nerve VII: facialCranial nerve VIII: vestibulocochlearCranial nerves IX and XCranial nerve XI: accessoryCranial nerve XII: hypoglossalMotor: applied anatomyMotor: inspection and toneMotor: upper limb powerMotor: lower limb powerTendon reflexesOther reflexesPrimitive reflexesSensory: applied anatomySensory examinationCoordinationSome peripheral nervesGaitThe unconscious patientImportant presenting patternsThe elderly patient

scholarly journals COVID-19 associated cranial nerve neuropathy: A systematic review

2021 ◽  
Author(s):  
Josef Finsterer ◽  
Fulvio Alexandre Scorza ◽  
Carla Scorza ◽  
Ana Fiorini
Keyword(s):  
Systematic Review ◽  
Peripheral Nerves ◽  
Cranial Nerve ◽  
Cranial Nerves ◽  
Complete Recovery ◽  
Intravenous Immunoglobulins ◽  
Partial Recovery ◽  
Cranial Nerve Involvement ◽  
Lethal Outcome ◽  
Nerve Involvement

The involvement of cranial nerves is being increasingly recognised in COVID-19. This review aims to summarize and discuss the recent advances concerning the clinical presentation, pathophysiology, diagnosis, treatment, and outcomes of SARS-CoV-2 associated cranial nerve mononeuropathies or polyneuropathies. Therefore, a systematic review of articles from PubMed and Google Scholar was conducted. Altogether 36 articles regarding SARS-CoV-2 associated neuropathy of cranial nerves describing 56 patients were retrieved. Out of these 56 patients, cranial nerves were compromised without the involvement of peripheral nerves in 32 of the patients, while Guillain-Barre syndrome (GBS) with cranial nerve involvement was described in 24 patients. A single cranial nerve was involved either unilaterally or bilaterally in 36 patients, while in 19 patients multiple cranial nerves were involved. Bilateral involvement was more prevalent in the GBS group (n=11) as compared to the cohort with isolated cranial nerve involvement (n=5). Treatment of cranial nerve neuropathy included steroids (n=18), intravenous immunoglobulins (IVIG) (n=18), acyclovir/valacyclovir (n=3), and plasma exchange (n=1). The outcome was classified as “complete recovery” in 21 patients and as ”partial recovery” in 30 patients. One patient had a lethal outcome. In conclusion, any cranial nerve can be involved in COVID-19, but cranial nerves VII, VI, and III are the most frequently affected. The involvement of cranial nerves in COVID-19 may or may not be associated with GBS. In patients with cranial nerve involvement, COVID-19 infections are usually mild. Isolated cranial nerve palsy without GBS usually responds favorably to steroids. Cranial nerve involvement with GBS benefits from IVIG.   

Neuritis ossificans of a cranial nerve

2010 ◽  
Vol 113 (5) ◽  
pp. 1112-1114 ◽  
Author(s):  
Craig M. Kemper ◽  
Julio C. Rojas ◽  
Steven Bauserman
Keyword(s):  
Differential Diagnosis ◽  
Peripheral Nerves ◽  
Cranial Nerve ◽  
Cranial Nerves ◽  
Rare Entity ◽  
Imaging Studies ◽  
Lower Cranial Nerve ◽  
Heterotopic Calcification ◽  
Lower Cranial Nerves ◽  
Nerve Disease

The authors report the case of intracranial neuritis ossificans presenting as chronic accessory neuropathy. Neuritis ossificans is a rare reactive nerve disease that has been reported to affect systemic peripheral nerves. To the best of the authors' knowledge, this is the first documented case of neuritis ossificans observed in a cranial nerve. The lesion was revealed on imaging studies and appeared, intraoperatively, as a nonsessile intradural lesion with significant calcification of rootlets of the lower cranial nerves. Microscopically, the lesion featured zonal heterotopic calcification typical of neuritis ossificans. Although it is a rare entity, neuritis ossificans can be considered in the differential diagnosis of lower cranial nerve neuropathy.

Impairment Tutorial: Rating Cranial Nerve and Spinal Cord Disorders

1997 ◽  
Vol 2 (2) ◽  
pp. 3-4
Author(s):  
Lorne Direnfeld
Keyword(s):  
Spinal Cord ◽  
Facial Nerve ◽  
Cranial Nerve ◽  
Cranial Nerves ◽  
Visual Fields ◽  
Anorectal Function ◽  
Bladder Function ◽  
Sensory Loss ◽  
Spinal Cord Disorders ◽  
Cranial Nerve Viii

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fourth Edition, discusses rating cranial nerve and spinal cord impairments. Evaluation of impairment of the cranial nerves is based on clinical neurological assessment, and many cranial nerves also are addressed in other chapters of the AMA Guides (eg, the visual system or the ear, nose, and throat). With respect to cranial nerve I, an impairment estimate associated with anosmia or parosmia should be given only if this significantly interferes with daily activities. For cranial nerve II, the AMA Guides recommends ophthalmologic testing of visual fields and best correction. For cranial nerves III, IV, and VI, the reader is referred to section 8.3, and, for cranial nerve V, the AMA Guides provides a method of determining impairment associated with trigeminal neuralgia. A table provides data regarding impairment for conditions that affect the seventh cranial (facial) nerve; sensory loss related to the facial nerve does not interfere with activities of daily living. Auditory impairment (cranial nerve VIII) is rated according to criteria in the ear, nose, throat, and related structures chapter, including tinnitus. Cranial nerves IX, X, XI, and XII are involved in breathing, swallowing, speaking, and some visceral functions, and ratings criteria are presented. In terms of spinal cord impairments, the AMA Guides divides pathology into six categories: station and gait; use of the upper extremities; respiration; urinary bladder function; anorectal function; and sexual function.

scholarly journals Resection of a Lower Clival Meningioma via Posterolateral Approach: Two-Dimensional Operative Video

2020 ◽  
Author(s):  
Pinar E. Ocak ◽  
Selcuk Yilmazlar
Keyword(s):  
Cranial Nerve ◽  
Cranial Nerves ◽  
Posterolateral Approach ◽  
Left Vertebral Artery ◽  
Posterior Arch ◽  
Upper Cervical Spine ◽  
Two Dimensional ◽  
Lower Cranial Nerve ◽  
Complex Anatomy ◽  
Microsurgical Resection

Abstract Objectives This study aimed to demonstrate resection of a craniovertebral junction (CVJ) meningioma via the posterolateral approach. Design The study is designed with a two-dimensional operative video. Setting This study is conducted at department of neurosurgery in a university hospital. Participants A 50-year-old woman who presented with lower cranial nerve findings due to a left-sided lower clival meningioma (Fig. 1). Main Outcome Measures Microsurgical resection of the meningioma and preservation of the neurovascular structures. Results The patient was placed in park-bench position and a left-sided retrosigmoid suboccipital craniotomy, followed by C1 hemilaminectomy and unroofing the lip of the foramen magnum, was performed. The dural incision extended from the suboccipital region down to the posterior arch of C2 (Fig. 2). The arachnoid overlying the tumor was incised, revealing the course of the cranial nerve (CN) XI on the dorsolateral aspect of the tumor. The left vertebral artery (VA) was encased by the tumor which was originating from the dura below the jugular foramen. The mass was resected in a piecemeal fashion eventually. At the end of the procedure, all relevant cranial nerves and adjacent vascular structures were intact. Postoperative magnetic resonance imaging (MRI) confirmed total resection and the patient was discharged home on postoperative day 3 safely. Conclusions Microsurgical resection of the lesions of the CVJ are challenging as this transition zone between the cranium and upper cervical spine has a complex anatomy. Since adequate exposure of the extradural and intradural segments of the VA can be obtained by the posterolateral approach, this approach can be preferred in cases with tumors anterior to the VA or when the artery is encased by the tumor.The link to the video can be found at: https://youtu.be/d3u5Qrc-zlM.

scholarly journals Intratumoral Bleeding in a Vestibular Schwannoma

2017 ◽  
Vol 37 (01) ◽  
pp. 47-49
Author(s):  
Emanuelle Braga ◽  
Luiza Köhler ◽  
Marcelo de Cesaro ◽  
Tasso Barreto ◽  
Richard Giacomelli ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Case Report ◽  
Cranial Nerve ◽  
Cerebellopontine Angle ◽  
Clinical Presentation ◽  
Cranial Nerves ◽  
Altered Consciousness ◽  
Progressive Hearing Loss ◽  
Asymptomatic Patients ◽  
Intratumoral Bleeding

AbstractVestibular schwannomas (VSs) account for ∼ 70% of all tumors of the cerebellopontine angle (CPA). Their clinical presentation is often insidious, with progressive hearing loss and involvement of other cranial nerves. Spontaneous hemorrhage in those tumors is very unusual, and generally presents with acute clinical features such as nausea, vomiting, headache and altered consciousness, usually with marked dysfunction of the cranial nerve involved, and with new deficits of neighboring cranial nerves. Asymptomatic patients are extremely rare. We present a case report of an incidental VS with asymptomatic bleeding, which evolved to death after surgery.

Isolated Congenital Absence of Cranial Nerves: Report of Two Cases

2018 ◽  
Vol 49 (06) ◽  
pp. 405-407
Author(s):  
Vivek Agarwal ◽  
Sumeet Dhawan ◽  
Naveen Sankhyan ◽  
Sameer Vyas
Keyword(s):  
High Resolution ◽  
Mr Imaging ◽  
Cranial Nerve ◽  
Clinical Presentation ◽  
Cranial Nerves ◽  
Rare Condition ◽  
Congenital Absence ◽  
The Third ◽  
Seventh Cranial Nerve ◽  
The Right

AbstractIsolated cranial nerve absence is a rare condition that can be diagnosed using high-resolution cranial nerve magnetic resonance (MR) imaging. Thorough clinical examination with proper knowledge of the course of cranial nerves may help diagnose this rare condition. We describe two cases, one each of, isolated congenital absence of the third and seventh cranial nerve with their clinical presentation. High-resolution T2-weighted MR imaging was done in both patients which revealed absence of cisternal segment of the right-sided third nerve and cisternal with canalicular segment of the right-sided facial nerve.

scholarly journals Internal Carotid Artery dissection presenting as Isolated Hypoglossal nerve palsy

2009 ◽  
Vol 8 (1) ◽  
pp. 22-25
Author(s):  
Amir Ahmad ◽  
◽  
Amir Ahmad ◽  
Philip Travis ◽  
Mark Doran ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cranial Nerve ◽  
Nerve Palsy ◽  
Internal Carotid ◽  
Cranial Nerves ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Internal Carotid Artery Dissection ◽  
Cranial Nerve Palsies

Internal carotid dissection most commonly presents as headache, focal neurological deficits or stroke. Rarely it can manifest itself by causing a palsy of the lower cranial nerves (IX, X, XI, XII). The reported incidence of isolated cranial nerve palsies is rare. We report a case of an internal carotid artery dissection manifesting as isolated XII (hypoglossal) cranial nerve palsy.

scholarly journals Clinical Correlations Delirium and other Comorbid in Elderly with COVID-19 Infection

2021 ◽  
Vol 5 (4) ◽  
pp. 886-889
Author(s):  
Khoirun Mukhsinin Putra ◽  
Nur Riviati ◽  
Djunaidi AR
Keyword(s):  
The Elderly ◽  
Decubitus Ulcer ◽  
Blurred Vision ◽  
Case Presentation ◽  
Mortality And Morbidity ◽  
Her Family ◽  
Atypical Symptoms ◽  
Presenting Symptoms ◽  
History Of ◽  
Isolation Ward

Background. Delirium is a common condition in geriatric patients. One of the trigger factors for this condition is an infection, such as COVID-19 infection. Elderly with COVID-19 show atypical symptoms such as delirium. Elderly patients with COVID-19 who present with delirium, either as a primary symptom or showing symptoms or signs, have a poor prognosis. This study were aimed to presents covid-19 elderly patient with comorbid delirium. Case presentation. A 77-year-old woman with disorientation for one day came to Emergency Department with her family. She had no history of headaches, blurred vision, or seizures. However, she had a fever, did not want to eat for three days, and had a purulent decubitus ulcer. The patient was diagnosed with acute delirium syndrome, confirmed COVID-19 with sepsis, malnutrition, hypercoagulation, grade III decubitus ulcer, suspected dementia, immobilization, total dependence. The patient admitted to the isolation ward. The patient had meropenem 500 mg every 12 hours, anticoagulants and favipiravir according to the dose and parenteral nutrition. Conclusion. Patients with COVID-19 who present with delirium, either as a primary symptom or presenting symptoms or signs, have a worse outcome. Delirium relationship with comorbid factors can increase mortality and morbidity in the elderly with COVID-19.

scholarly journals Management of Peripheral Neuropathy and Cardiovascular Effects in Vitamin B12 Deficiency

2021 ◽  
Vol 10 (5) ◽  
Author(s):  
Nishant Kumar Singh ◽  
Hirni J. Patel ◽  
Mohit Buddhadev ◽  
S P Srinivas Nayak ◽  
Gunosindhu Chakraborthy
Keyword(s):  
Cardiovascular Disease ◽  
Peripheral Neuropathy ◽  
Vitamin B12 ◽  
Peripheral Nerves ◽  
Vitamin B12 Deficiency ◽  
Cardiovascular Effects ◽  
The Elderly ◽  
Vitamin Deficiencies ◽  
B12 Deficiency ◽  
Artery Disease

Peripheral nerves are susceptible to damage by a wide array of toxins, medications, and vitamin deficiencies. Vitamin B12 (VB12) deficiency neuropathy is a rare debilitating disease that affects mostly the elderly. It is important to consider these etiologies when approaching patients with a variety of neuropathic presentations in this review were have included most relevant and latest information on mechanisms causing Peripheral neuropathy in VB12 deficiency. We also have included cardiovascular disorders and their management. Hyperhomocysteinemia has been implicated in endothelial dysfunction and cardiovascular disease. The association of homocysteine (Hcy) and VB12 with cardiovascular risk factors in patients with coronary artery disease (CAD) has also been studied Keywords: Peripheral Neuropathy, Vitamin B12 Deficiency, Cardiovascular Disease and Homocysteine.

scholarly journals Hemorrhagic vestibular schwannoma: an unusual clinical entity

1998 ◽  
Vol 5 (3) ◽  
pp. E14 ◽  
Author(s):  
Dean Chou ◽  
Prakash Sampath ◽  
Henry Brem
Keyword(s):  
Vestibular Schwannoma ◽  
Cranial Nerve ◽  
Unusual Case ◽  
Case Reports ◽  
Clinical Entity ◽  
Vestibular Schwannomas ◽  
Presenting Symptoms ◽  
Cranial Nerve Dysfunction ◽  
Nerve Dysfunction ◽  
Management Issues

Hemorrhagic vestibular schwannomas are rare entities, with only a few case reports in the literature during the last 25 years. The authors review the literature on vestibular schwannoma hemorrhage and the presenting symptoms of this entity, which include headache, nausea, vomiting, sudden cranial nerve dysfunction, and ataxia. A very unusual case is presented of a 36-year-old man, who unlike most of the patients reported in the literature, had clinically silent vestibular schwannoma hemorrhage. The authors also discuss the management issues involved in more than 1000 vestibular schwannomas treated at their institution during a 25-year period.

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