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Cranial Nerves
Cranial Nerves

Occulomotor Limitation


Oculomotor Nerve (III) Palsy

  • Look For

  • Eye deviated down and out
  • Diplopia
  • Ptosis
  • Mydriasis (pupillary dilatation)
  • Loss of pupillary reflexes
  • Causes of Occulomotor Nerve Palsy

  • Small-vessel ischaemia
  • Midbrain infarct
  • Head trauma
  • Tumour
  • Aneurysm (commonly PCA)

Trochlear Nerve (IV) Palsy

  • Look For

  • Head tilting away from the side of the lesion
  • Eye deviation upward and rotation outward
  • Vertical diplopia
  • Inability to look down and in - difficulty descending stairs
  • Causes of Trochlear Nerve Palsy

  • Congenital absence
  • Closed head injury
  • Small-vessel ischaemia
  • Multiple sclerosis

Abducens Nerve (VI) Palsy

  • Look For

  • Inwardly-turned eye
  • Horizontal diplopia
  • Inability to look laterally
  • Causes of Palsy

  • Small-vessel ischaemia
  • Head trauma
  • Tumour
  • Aneurysm
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