Survey on Olfactory Testing by Pediatric Neurologists: Is the Olfactory a “True” Cranial Nerve?

2020 ◽  
Vol 35 (5) ◽  
pp. 317-321 ◽  
Author(s):  
Harvey B. Sarnat ◽  
Laura Flores-Sarnat
Keyword(s):  
North American ◽  
Cranial Nerve ◽  
Genetic Disorders ◽  
Genetic Diseases ◽  
Cranial Nerves ◽  
The United States ◽  
Olfactory Nerve ◽  
Multiple Choice Questions ◽  
Olfactory Testing ◽  
The Brain

Background: The olfactory nerve was conceptualized in the 4th century BC by Alcmaeon and described anatomically by Winslow in 1733. Cranial nerves (CNs) were named and numbered by Soemmerring in 1791. Notions still prevail that the olfactory (CN1) is not a “true” cranial nerve. Methods: To confirm our impression that the olfactory nerve is infrequently tested by North American pediatric neurologists, a survey was distributed to members of national pediatric neurology societies in Mexico, Canada, and the United States. A total of 233 responses were received to 6 multiple-choice questions regarding practice patterns examining CN1 in neonates and children and in metabolic, endocrine, and genetic disorders and cerebral malformations. Two of the questions addressed familiarity with neonatal olfactory reflexes and asked whether the olfactory is a “true” cranial nerve. Results: Only 16% to 24% of North American pediatric neurologists examine CN1 in neonates, even in conditions in which olfaction may be impaired. About 40% of respondents were aware of olfactory reflexes. A minority 15% did not consider CN1 as a “true” cranial nerve. Conclusions: Olfactory evaluation in neonates is simple, rapid, and inexpensive. It tests parts of the brain not otherwise examined. It may assist diagnosis in cerebral malformations; metabolic, endocrine, and hypoxic encephalopathies; and some genetic diseases, including chromosomopathies. CN1 is neuroanatomically unique and fulfills criteria of a true sensory cranial nerve. We recommend that olfaction be routinely or selectively included during neurologic examination of neonates and children.

The neuropsychological function of the 12 cranials nerves

2011 ◽  
Vol 26 (S2) ◽  
pp. 417-417
Author(s):  
S. Frohlich ◽  
C.A. Franco
Keyword(s):  
Cranial Nerve ◽  
Cranial Nerves ◽  
Olfactory Nerve ◽  
Spinal Nerve ◽  
Neuropsychological Function ◽  
Trochlear Nerve ◽  
Abducent Nerve ◽  
Behavioral Attitudes ◽  
The Brain ◽  
Cognitive Attitude

The cranial nerves can be an important key for research in Neuropsychology. Our hypothesis is that they can be organized in three groups and then, related to specifics attitudes.The Cochlear Nerve (VII pair), the Optic Nerve (II pair) and the olfactory nerve (I pair) have special translators that process the sensorial information from the environment to the brain, to form a clue. They are the first cranial nerve group: the cognitive nerves that incite the nervous system in an endogenous way. The second cranial nerve group stimulates muscles: the spinal nerve (XI pair) that regulates the posture, the trigeminal nerve (V pair) that is connected to mastication muscles and the hypoglossal nerve (XII pair) that supplies motor fibers for all the tongue muscles. They are behavioral nerves and act in an exogenous way.The third cranial nerve group regulates the emotions and is connected to the SNA: the Vagus nerve (X pair), the Facial nerve (VII pair) and the Glossofaringeal nerve (IX pair).The cranial nerves that enervate the eyes muscles are responsible for the regulation of the visual focus and the attention. We related them to the three groups above described. The Trochlear nerve (IV pair) incite a cognitive attitude and act in an endogenous way; the Abducent nerve (VI pair) produces the plain environmental attention through the saccades and following eyes movement and produces behavioral attitudes and the Oculomotor Nerve (III pair) act in autonomic way, regulating the inner feelings and emotions.

Unknown fatal encephalomyelopolyradiculoneuritis in a child. A case report

2021 ◽  
Vol 2 (2) ◽  
pp. 100-106
Author(s):  
Aleksandra I. Pavlyuchkova ◽  
Aleksey S. Kotov
Keyword(s):  
Spinal Cord ◽  
Cerebrospinal Fluid ◽  
Genetic Diseases ◽  
Cranial Nerves ◽  
Unknown Etiology ◽  
Active Therapy ◽  
Nerve Roots ◽  
Child Patient ◽  
Brain And Spinal Cord ◽  
The Brain

In childhood, various infectious, autoimmune, genetic diseases can manifest. We present a case of fatal encephalomyelopolyradiculoneuritis of unknown etiology in a 9-year-old child. Patient N.K. in February 2019, noted an increase in temperature to subfebrile values, received symptomatic and antibiotic therapy without effect. An increase in protein and lymphocytes was found in the cerebrospinal fluid. According to MRI data, the emergence of more and more foci of the pathological signal in the brain and spinal cord, cranial nerves and nerve roots of the lumbar plexus was noted. Known infectious and autoimmune diseases were excluded. Despite active therapy with glucocorticoids, antibiotics, antiviral drugs, immunoglobulin, the disease continued to progress, and the patient died in April 2020.

Cranial nerves

2018 ◽  
Author(s):  
Arangasamy Anbarasu ◽  
Jack I. Lane
Keyword(s):  
Cranial Nerve ◽  
Special Functions ◽  
Cranial Nerves ◽  
Facial Movement ◽  
The Brain

This section discusses the cranial nerve. Cranial nerves are important structures involved with special functions of smell, sight, lacrimation, hearing, balance, taste, facial movement, mastication and swallowing. There are twelve pairs of cranial nerves which are named anatomically by the level at which they exit the brain and brainstem, with lower numbered cranial nerves exiting superior and anterior to higher numbered ones.

Cranial Nerves and Cranial Nerve Nuclei

2017 ◽  
Author(s):  
Peggy Mason
Keyword(s):  
Cranial Nerve ◽  
Cranial Nerves ◽  
Sensory Information ◽  
Abducens Nerve ◽  
Motor Information ◽  
Anatomical Arrangement ◽  
Cranial Nerve Injuries ◽  
Nerve Dysfunction ◽  
The Common ◽  
The Brain

The functions of cranial nerves, conduits for sensory information to enter and motor information to exit the brain, and the common complaints arising from cranial nerve injuries are described. The modified anatomical arrangement of sensory and motor territories in the brainstem provides a framework for understanding the organization of the cranial nerve nuclei. A thorough grounding in the anatomy of cranial nerves and cranial nerve nuclei allows the student to deduce whether a given set of symptoms arises from a central or peripheral lesion. The near triad, pupillary light reflex, and Bell’s palsy are particularly emphasized. The contributions of the six extraocular muscles to controlling eye position and to potential diplopia are described along with the consequences of oculomotor, trochlear, and abducens nerve dysfunction. The potential for lesions of facial, glossopharyngeal, vagus, and hypoglossal nerves to yield dysphagia and dysarthria are outlined.

Low grade b-cell non-Hodgkin lymphomas (NHL) involving the central nervous system (CNS): An analysis from the National Cancer Database (NCDB).

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e13083-e13083 ◽  
Author(s):  
Priyanka Avinash Pophali ◽  
Gita Thanarajasingam ◽  
Jose Pulido ◽  
Patrick B. Johnston ◽  
Ronald S. Go
Keyword(s):  
Spinal Cord ◽  
Nervous System ◽  
B Cell ◽  
Cranial Nerves ◽  
Case Series ◽  
The United States ◽  
Age At Diagnosis ◽  
Low Grade ◽  
Cns Involvement ◽  
The Brain

e13083 Background: CNS involvement from low grade B-cell NHL is rare and has only been reported as case series. The distribution, demographics and outcomes of patients with low grade B-cell CNS NHLs have not been well characterized. Methods: The NCDB represents ~70% of cancer cases in the United States. Using the 2004-2013 NCDB extranodal NHL database, we identified all CNS B-cell NHLs based on ICD-O-3 site and histology codes. Primary or secondary CNS involvement could not be determined. Results: Out of 9435 CNS NHL cases, 475 [5.03%] had low grade histologies. In this group, the median age at diagnosis was 58 years [range 19-89]. Majority of the cases were female [56%], White, non-Hispanic [72%], privately insured [53%], with no comorbidities [74%] and treated in academic/research programs [38%]. Site of CNS disease was not specified in 22%. HIV status was known in 318 cases (6.3% positive). The brain [44%] was the most common site of involvement followed by spinal cord [19%] and meninges [15%]. Follicular lymphoma (FL) [48%] was the most common histology overall followed by marginal zone (MZL) [37%], small lymphocytic (SLL) [8%] and lymphoplasmacytic lymphomas (LPL) [7%]. MZL was the most common histology in the brain [44%] and meninges [61%] while FL was most common in the spinal cord [77%] and nervous system, NOS [69%]. Cranial nerves and eye (retina/optic nerve) involvement was very rare [2 and 1 case each- both MZL]. The overall survival (OS) of CNS B-cell NHL was significantly better if histology was low grade vs other [5-year OS 74% vs 32%, P < 0.0001]. Among CNS low grade B-cell NHLs, 5-year OS varied by histology [MZL 83%, FL 75%, LPL 56% and SLL 50%, P = 0.0003] and site of disease [spinal cord 89%, meninges 78% and brain 63%, P = 0.03] in addition to age at diagnosis and co-morbidities on both uni- and multivariate analysis. Survival was not influenced by sex, race, insurance, year of diagnosis, facility type or location. Conclusions: CNS involvement with low grade B-cell NHL is rare but has a relatively good outcome with most patients surviving beyond 5 years. FL and MZL are the more common low grade histologies. Both histology and disease site are important factors affecting survival.

Brain Stem and Cranial Nerve Monitoring

2016 ◽  
pp. 788-798
Author(s):  
Brian A. Crum
Keyword(s):  
Brain Stem ◽  
Cranial Nerve ◽  
Cranial Nerves ◽  
Neck Region ◽  
Accurate Identification ◽  
Nerve Monitoring ◽  
Motor Pathways ◽  
Cranial Nerve Function ◽  
The Brain ◽  
Clinical Deficits

Cranial nerves can be injured during surgical procedures performed in the middle and posterior cranial fossae as well as in the head and neck region. Damage results from compression, stretch, abrasion, or ischemia of the nerve. If axonal disruption occurs, recovery is limited, resulting in significant clinical deficits. Cranial nerve function can be monitored during anesthesia by recording spontaneous or stimulus-evoked electrical activity directly from the nerve or the cranial muscles. Activity in other pathways in the brain stem can be monitored by following changes in evoked potentials of sensory and motor pathways. These methods can detect damage to either the intra-axial or the extra-axial portion of cranial nerves and can localize cranial nerves during an operation when normal anatomy is altered, making accurate identification of nerves difficult. Finally, information from intraoperative cranial nerve monitoring may lead to an altered surgical plan to preserve neurological function.

scholarly journals The Brain-Nose Interface: A Potential Cerebrospinal Fluid Clearance Site in Humans

2022 ◽  
Vol 12 ◽  
Author(s):  
Neel H. Mehta ◽  
Jonah Sherbansky ◽  
Angela R. Kamer ◽  
Roxana O. Carare ◽  
Tracy Butler ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Animal Species ◽  
Immune Surveillance ◽  
Cranial Nerves ◽  
Extracellular Fluid ◽  
Olfactory Nerve ◽  
Brain Functions ◽  
Treatment Considerations ◽  
Physiological Homeostasis ◽  
The Brain

The human brain functions at the center of a network of systems aimed at providing a structural and immunological layer of protection. The cerebrospinal fluid (CSF) maintains a physiological homeostasis that is of paramount importance to proper neurological activity. CSF is largely produced in the choroid plexus where it is continuous with the brain extracellular fluid and circulates through the ventricles. CSF movement through the central nervous system has been extensively explored. Across numerous animal species, the involvement of various drainage pathways in CSF, including arachnoid granulations, cranial nerves, perivascular pathways, and meningeal lymphatics, has been studied. Among these, there is a proposed CSF clearance route spanning the olfactory nerve and exiting the brain at the cribriform plate and entering lymphatics. While this pathway has been demonstrated in multiple animal species, evidence of a similar CSF egress mechanism involving the nasal cavity in humans remains poorly consolidated. This review will synthesize contemporary evidence surrounding CSF clearance at the nose-brain interface, examining across species this anatomical pathway, and its possible significance to human neurodegenerative disease. Our discussion of a bidirectional nasal pathway includes examination of the immune surveillance in the olfactory region protecting the brain. Overall, we expect that an expanded discussion of the brain-nose pathway and interactions with the environment will contribute to an improved understanding of neurodegenerative and infectious diseases, and potentially to novel prevention and treatment considerations.

scholarly journals Lyme Disease Presenting with Multiple Cranial Nerve Deficits: Report of a Case

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Abhishek Chaturvedi ◽  
Keith Baker ◽  
Donald Jeanmonod ◽  
Rebecca Jeanmonod
Keyword(s):  
United States ◽  
Lyme Disease ◽  
Borrelia Burgdorferi ◽  
Inflammatory Disease ◽  
Cranial Nerve ◽  
Cranial Nerves ◽  
The United States ◽  
Vector Borne Disease ◽  
Vector Borne ◽  
Multiple Cranial Nerve

Lyme disease is a tick-transmitted multisystem inflammatory disease caused by the spirocheteBorrelia burgdorferi. With more than 25,000 CDC reported cases annually, it has become the most common vector-borne disease in the United States. We report a case of 38-year-old man with Lyme disease presenting with simultaneous palsy of 3rd, 5th, 7th, 9th, and 10th cranial nerves.

scholarly journals Hypoglossal canal schwannoma causing isolated left 12th cranial nerve palsy

2018 ◽  
pp. bcr-2018-225544 ◽  
Author(s):  
Shruti Heda ◽  
Davala Krishna Karthik ◽  
Erigaisi Srinivas Rao ◽  
Anirudda Deshpande
Keyword(s):  
Clinical Features ◽  
Cranial Nerve ◽  
Cranial Nerve Palsy ◽  
Nerve Palsy ◽  
Cranial Nerves ◽  
Left Half ◽  
Hypoglossal Canal ◽  
Insidious Onset ◽  
12Th Cranial Nerve ◽  
The Brain

A 40-year-old woman presented with insidious onset, gradually progressive dysarthria and inability to manoeuvre bolus of food in her mouth while eating. The duration of her symptoms was 3 months. On evaluation, the left half of her tongue was wasted. The tongue deviated to the left on protrusion. There were no clinical features suggestive of involvement of the ipsilateral 9th, 10th or 11th cranial nerves. MRI of the brain showed a large, fusiform lesion in the left hypoglossal canal, extending into the jugular canal. The lesion was surgically excised and found to be a schwannoma.

Osteopetrosis in a young adult dog causing multiple cranial nerve deficits

2019 ◽  
Vol 7 (3) ◽  
pp. e000856
Author(s):  
James Elford ◽  
Andrew T Parry ◽  
Sebastien Behr
Keyword(s):  
Cranial Nerve ◽  
Cranial Nerves ◽  
Rare Condition ◽  
Serum Biochemistry ◽  
Total Calcium ◽  
Vitamin D Levels ◽  
Ionised Calcium ◽  
Mild Anaemia ◽  
Sporadic Cases ◽  
The Brain

A two-year-old Cocker Spaniel was presented for investigation of lethargy and cranial nerve deficits. Neurological examination revealed multiple cranial nerves deficits and haematology and serum biochemistry revealed mild anaemia. MRI of the brain revealed caudoventral cerebellar herniation and cervical syringohydromyelia, while both MRI and CT revealed hyperostosis of the calvarium and narrowing of the calvarial foramina. Radiographs demonstrated marked osteosclerosis of the skull, vertebrae, sternebrae, ribs and long bones of the limbs. Further biochemistry revealed total calcium, ionised calcium and vitamin D levels to be unremarkable. This led to a diagnosis of osteopetrosis. Osteopetrosis is an extremely rare condition in dogs, with only sporadic cases being reported previously in the literature.

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