Jonathan Kennedy

Cranial Nerve Disorders

Syphilis, chronic meningitis (tends to pick off lower CN one by one). Olfactory (I) Nerve • Anatomy: Olfactory cells are a series of bipolar neurones which pass through the cribriform plate to the olfactory bulb. • Signs: Reduced taste and smell, but not to ammonia which stimulates the pain fibres carried in the trigeminal nerve. • Anatomy: The optic nerve fibres are the axons of the retinal ganglion cells. Fibres from the nasal parts of retina decussate at optic chiasm, join with the non-decussating fibres and pass back in optic tracts to visual cortex. • Signs and causes: o Visual field defects: Field defects start as small areas of visual loss (scotomas). Monocular blindness: Lesions of one eye or optic nerve eg MS, giant cell arteritis. Bilateral blindness: Methyl alcohol, tobacco amblyopia; neurosyphilis. Bitemporal hemianopia: Optic chiasm compression eg internal carotid artery aneurysm, pituitary adenoma or craniopharyngioma Homonymous hemianopia: Affects half the visual field contralateral to the lesion in each eye. Lesions lie beyond the optic chiasm in the tracts, radiation or occipital cortex e.g. stroke, abscess, tumour. • Anatomy Emerges from brainstem on medial aspect of the crus cerebri and passes forwards between posterior cerebral and superior cerebellar arteries, very close to the

Neurology for MRCP: The Essential Guide to Neurology for MRCP Part 1, Part 2 and PACES

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