Disorders Of Iii. Cranial Nerves

Disorders of III. Cranial nerves can affect the ocular motility, the function of the pupil, or both. Symptoms and complaints are: diplopia, ptosis and paresis of Augenadduktion and the construction and Abblicks. If the pupil is concerned, they will be expanded, and the light reaction is disturbed. If the pupil is affected or the patients do not respond increasingly, a neurological imaging is performed as soon as possible.

Disorders of III. Cranial nerves can affect the ocular motility, the function of the pupil, or both. Symptoms and complaints are: diplopia, ptosis and paresis of Augenadduktion and the construction and Abblicks. If the pupil is concerned, they will be expanded, and the light reaction is disturbed. If the pupil is affected or the patients do not respond increasingly, a neurological imaging is performed as soon as possible. Etiology disorders of the third brain nerve (oculomotor) which cause paralysis and often impair the pupil, resulting from aneurysm (especially the posterior communicating artery) Transtentorieller Gehirnprolaps Less frequently, meningitis, which affects the brain stem (z. B. TB meningitis) the most common cause of paralysis with opening of the pupil, v. a. partial paralysis, are ischemia of the III. Cranial nerve (usually by diabetes mellitus or hypertension) or the midbrain occasionally caused an arterial aneurysm of the posterior communicating artery a oculomotor palsy with opening of the pupil. Symptoms and complaints diplopia and ptosis (drooping upper eyelid) occur. The affected eye may vary slightly in primary gaze outward and downward; adduction is slow and can not walk the center line to above. The Aufblick is disturbed. When trying to look down, the superior oblique muscle triggers a slight abduction and rotation of the eye. The pupil may be normal or extended; their reaction to direct and consensual light may be sluggish or absent (efferent defect). Mydriasis (pupil dilation) may be an early sign. Diagnosis Clinical evaluation CT or MRI Among the differential diagnoses brain lesions that disrupt oculomotor fascicles (Claude syndrome, Benedikt syndrome) Leptomeningeal (r) tumor or infection sinus cavernous syndrome (Giant carotid aneurysm, fistulas or thrombosis) intraorbital structural lesions (z. B. orbital mucormycosis), which limits the ocular motility. Ocular myopathy (eg, due to hyperthyroidism or mitochondrial diseases) diseases of the neuromuscular junction (eg. As a result of myasthenia gravis or botulism) The differentiation can be made clinically. A exophthalmus or Endophthalmus, a history of severe trauma in orbita or obviously inflamed orbit suggest a structural intraorbital disorder. Endocrine ophthalmopathy in Graves’ disease should be considered in patients with bilateral ocular paralysis, paresis of Aufblick or abduction, proptosis, lid retraction, lagging the eyelid at lowering the gaze down (Graefe’s sign) and a normal pupil. CT or MRI are required. A patient shows a dilated pupil and sudden, severe headache (which speaks for a ruptured aneurysm), or it reacts less and less (indicating herniation), should immediately CT are performed. Consists of V. a. a ruptured aneurysm and displays the CT (or MRI) no blood or is not in stock, other tests such as lumbar puncture, MR or CT angiography, or cerebral angiography are displayed. Cavernous sinus syndrome and orbital mucormycosis require immediate MRI imaging for timely treatment. Treatment Treatment depends on the cause.

Health Life Media Team

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