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Neurology

Question
10 out of 25
 

In mimic paralysis



A Voluntary movement of face is impaired

B Emotional movement of face impaired

C Both

D None

Ans. B

Emotional movement of face impaired

Mimic Paralysis

It is due to frontal or thalamic lesions Q, which abolish the C/L emotional movements of the face, leaving the voluntary movement unimpaired

Extra Edge:

1). IX Cranial Nerve (Glossopharyngeal nerve)

It supplies taste sensation to post. third of tongue. It also supplies stylopharyngeus muscleQ.

2). X Cranial nerve – (Vagus nerve)

a. It is the longest cranial nerve. It supplies ms. of soft palate except tensor palati Q, pharynx, larynx. It also supplies resp. tract, heart and abdominal viscera.

b. Dysphagia

i. To solid food – UMN type

ii. To liquid – LMN type

3). Tests –

Usually both IX and X cranial nerves are tested simultaneously

a. Taste from post. 1/3 of tongue.

b. Palatal reflex – Elevation of soft palate on both sides and position of uvula is noted.

i. Unilateral palatal palsy – The palatal arch on that side is at a lower level than on the healthy side.

ii. On saying ‘ah’ the uvula is pulled to the healthy side by normal palate.

iii. B/L palatal palsy – The palate remains immobile on both sides.

c. Palatal myoclonus – Seen in autosomal dominant cerebellar ataxia or olivopontocerebellar Q atrophy. This movement is present even during sleep.

Site of lesion - Triangle of Guillain and Mollaret (Triangle formed b/w Red nucleus, Dentate nucleus and olivary nucleus)

d. Gag reflex

i. Absent – LMN type of palsy

ii. Exaggerated – UMN (Pseudobulbar palsy)

XI Cranial nerve (Accessory nerve)

Two parts:

1). Cranial

2). Spinal

a. The spinal part arise from lat. column of spinal cord foramen magnum Joins cranial part Emerge through Jugular foramen.

b. It supplies trapezius and sternocleidomastoid.

Lesion of IX, X, XI

Site

Causes

Clinical features

Jugular foramen

Glomus tumour

IX, X + weakness of trapezius &

(Vernet syndrome)

Meningioma

sternocleidomastoid

XIIth cranial nerve

Hypoglossal nucleus (in the floor of 4th ventricle) Hypoglossal canal of the skull Neck Tongue

LMN palsy

UMN palsy

1). Wasting –

Present

absent

2). Fibrillation –

Present

absent

3). Protrusion –

Possible

Difficult

4). Tongue

Flaccid

Spastic

5). Jaw jerk –

Normal

Exaggerated

Neurology Flashcard List

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