EMQs in Clinical Medicine.pdf - Peshawar Medical College

Cranial nerve lesions 79
33 Cranial nerve lesions
A
B
C
D
E
F
V, VII, VIII, IX lesion
right XII lesion
left XII lesion
right XI lesion
IX lesion
IV, V, VII lesion
G
H
I
J
K
L
V lesion
left XI lesion
V, VII, VIII lesion
IX, X lesion
VI lesion
IV lesion
Which cranial nerve lesion(s) is(are) responsible for the symptoms and signs
described below
1 A 55-year-old man presents with unilateral weakness, wasting and fasciculation
of the tongue. On examination the tongue deviates to the left on protrusion.
2 A 44-year-old man presents with progressive perceptive deafness, vertigo, unilateral
facial weakness and loss of sensation on that side of the face. Imaging
reveals the presence of a cerebellopontine tumour.
3 A patient complains of a hoarse voice, difficulty in swallowing and choking
when drinking fluids. Examination reveals visible weakness of elevation of the
palate, depression of palatal sensation and loss of the gag reflex.
4 A 28-year-old man presents after surgery with an inability to rotate the head to
the right and to shrug the left shoulder.
5 A 35-year-old woman with multiple sclerosis complains of diplopia. Examination
reveals inability to abduct pupil on one side.
Answers: see page 95.