EMQ practice - Cranial nerve lesions

• 55 Year old, Male, Unilateral weakness, Wasting, Fasiculation of the tongue, Tongue deviates to the left on protrusion
• Left CN 12 lesion
• Tongue deviates to the side of the lesion
• 44 Year old, Male, Progressive perceptive deafness, Vertigo, Unilateral facial weakness, Loss of sensation on that side of the face, Imaging reveals presence of a cerebellopontine tumour
• CN5, 7 and 8 lesion
• Cerebellopontine tumours often present clinically as a result of impingement on cranial nerves in the cerebellopontine angle
• Hoarse voice, Difficulty in swallowing and choking while drinking fluids, Visible weakness of elevation of the palate, Depression of palatal sensation and loss of gag reflex
• CN9, 10 lesion
• Cranial nerve IX and X lesions rarely occur in isolation and can also accompany nerve XI and XII lesions after infarction in the brain stem or as a result of pathology around the jugular foramen
• 28 Year old, Male, Surgery, inability to rotate the head to the right and shrug the left shoulder
• Left CN11 lesion
• Accessory nerve is the motor supply to the trapezius and sternocleidomastoid. The latter muscle allows rotation of the head to the opposite side
• 35 Year old, Female, Multiple sclerosis, Diplopia, Inability to abduct pupil on one side
• CN6 lesion
• Diplopia in multiple sclerosis can result from demyelination of cranial nerves associated with eye movements, i.e. III, IV, and VI