1Institute of Neurophysiology and Cellular Biophysics, Georg-August-Universität Göttingen, 2Center for Nanoscale Microscopy and Molecular Physiology of the Brain, Georg-August-Universität Göttingen, 3DFG Excellence Cluster 171, Georg-August-Universität Göttingen, 4German Hearing Center Hannover
1UPRES EA3830, Institute for Research and Innovation in Biomedicine, University of Rouen, 2Neuroscience, Karolinska Institutet, 3Otorhinolaryngology, Head and Neck Surgery Department, Rouen University Hospital, 4Otorhinolaryngology, Head and Neck Surgery Department, Amiens University Hospital
Source:Tracey A. Milligan, MD; Tamara B. Kaplan, MD; Neurology, Brigham and Women's/Massachusetts General Hospital, Boston, Massachusetts, USA
During each section of the neurological testing, the examiner uses the powers of observation to assess the patient. In some cases, cranial nerve dysfunction is readily apparent: a patient might mention a characteristic chief complaint (such as loss of smell or diplopia), or a visually evident physical sign of cranial nerve involvement, such as in facial nerve palsy. However, in many cases a patient's history doesn't directly suggest cranial nerve pathologies, as some of them (such as sixth nerve palsy) may have subtle manifestations and can only be uncovered by a careful neurological exam. Importantly, a variety of pathological conditions that are associated with alterations in mental status (such as some neurodegenerative disorders or brain lesions) can also cause cranial nerve dysfunction; therefore, any abnormal findings during a mental status exam should prompt a careful and complete neurological exam.
The cranial nerve examination is applied neuroanatomy. The cranial nerves are symmetrical; therefore, while performing the examination, the examiner should compare each side to the other. A physician should approach the examination in a …
Physical Examinations III