3 Palsy Case Studies

Normocephalic atraumatic. Pupils equally round and reactive to light, extraocular motions intact. Oral cavity shows oropharynx clear but slightly dried mucosal membranes. TM (tympanic membranes) clear. Neck, supple. There is no thyromegaly, no JVD. No cervical supraclavicular, axillary, or inguinal lymphadenopathy.

L.H. report no concurrent or severe headaches; There was no head trauma, syncope or vertigo. Patient wears corrective lens with no difficulty of vision or diplopia; absent of inflammation, discharge or lesion. Last eye exam was in September of 2016 with no history of glaucoma, cataracts. L.H. denies having any frequent colds, sinusitis, epistaxis and trauma. Patient reports having obstruction stating, “it happens when I am lying down” with an occasional postnasal drip.

Visual fields full to confrontation. Extraocular muscles intact. PERRLADC. Normal facial symmetry, sensation and movement. Tongue and uvula were midline. Normal auditory acuity. Shoulder shrug is normal.

Patient is a 23-year-old right-hand white female who presents with her mother for evaluation of post concussive syndrome. She had two significant closed head injuries this winter in February. They both occurred while snowboarding. On the first one, she slipped on some ice fell back and hit her occiput. She was wearing a helmet. When she got down to the bottom of the hill, she noted she had some mild confusion. Her friend asked her where she fell and she was unable to recall exactly where in the course she fell. She had a mild headache and was sleepy the rest of that day. One week later, she had another strike to the occiput. Again, she was wearing a helmet. She did have a headache

He also had right more than left mastoid opacifications and states that he was recently treated for otitis media. He has hypertension, hyperlipidemia, coronary disease and had been noncompliant with his medications in the past. His exam was essentially normal except for the subjective vertigo. There was no nystagmus and no diplopia on the initial exam. On 06/19/2015, he gave a different history. He states that he had a strike to the left temporal on Tuesday 06/16/2015. This did not result in any vertigo or any other neurological symptoms at that time. It was two days later that he had the vertigo at work. The patient also claimed that he had been seeing double since the previous night and the morning of the 19th. However, his neurological exam at that time, failed to reveal any actual disconjugate gaze. The patient had an MRI MRA, which revealed old white matter ischemic disease and mild intracranial atherosclerosis, but no evidence for acute stroke or posterior circulation significant stenosis. His diagnosis was labyrinthitis, possibly due to his bilateral mastoiditis. He was treated with Augmentin for 10 days. His symptoms resolved prior to discharge on meclizine. On physical therapy on discharge, he had no

First of all, it is necessary to understand some of the important features of this syndrome (Naeye,

The symptons include facial disformities including downward slanting eyes, smaller lower jaw (also referred to as micrognathia),underdevloped zygoma, drooping

Visual fields full to confrontation. Extraocular muscles intact. PERRLADC. Normal facial symmetry, sensation, and movement. Tongue and uvula were midline. Decreased auditory acuity bilaterally. Normal shoulder shrug.

I noticed nystagmus in both eyes at maximum deviation. Mcclellan also had involuntary movement in both eyes prior to 45 degrees.

Patient denies any signs or symptoms of GI bleeding, N/V/D, bloody stool, chest pain, SOB, or blurred vision. Patient was in a fight over 20 years ago and has facial bone damage, now that is affecting his vision. Requesting community resources Patient was seen at Calhoun Eye Center several years ago.

Contralateral weakness of the lower face, hands, arms and legs; transient dysphasia; numbness or loss of sensation; headache; temporary loss of vision of one eye; sudden inability to speak. Other symptoms may include: tinnitus, vertigo, blurred vision, diplopia, eyelid ptosis and ataxia.

The signs fall into two categories: optic neuritis and transverse myelitis. Optic neuritis is inflammation of the optic nerve and can result with pain inside the eye, unclear vision, or blindness. Optic neuritis usually occurs in one eye, but can happen in both. Transverse myelitis is inflammation of the spinal cord. This inflammation can result in pain, weakness, numbness, or paralysis of the arms and legs. It could also result in loss of control of the bladder and bowel. Side effects could result in nausea, hiccups, headaches, or a stiff neck. Symptoms and signs for children who have neuromyelitis optica include confusion, seizures, or

Visual fields full to confrontation. Extraocular muscles intact. PERRLADC. Normal facial symmetry, sensation and movement. Tongue and uvula were midline. Normal auditory acuity. Normal shoulder shrug.

First, inspect the head and heck when obtaining the objective data. The scalp, hair, and cranium should are reviewed for any deformities, lumps, or tenderness. Secondly, review the face for any changes to facial expression, symmetry, or involuntary movements. Any changes in the face may be a reflection of problem to Cranial Nerve 7. Next is the assessment of the temporal artery and the mandibular joint. The patient will open and close their mouth at least twice to ensure there are no deficiencies in this area. Lastly, is the observation of the maxillary and frontal sinuses and inspect for any swelling or tenderness.

A 31 year old male presented to the outpatient department of the University Hospital of the West Indies with a one year history of weakness of the upper limbs that had been affecting his function at school. He was also complaining of headaches that were located mostly over the frontal area of the head and were aggravated by sneezing and coughing. He denied any vertigo, vomiting, lateralising weakness, fever or neck stiffness. On examination, he had a Glasgow Coma Score (GCS) of 15 with no cranial nerve deficits. No cerebellar signs were elicit, he however had grade IV/V