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Cheatography

Face + Jaw - CN V & VII Cheat Sheet (DRAFT) by

Disorders + diagnosis of face + Jaw - CN V & VII

This is a draft cheat sheet. It is a work in progress and is not finished yet.

Sensation of V

Pattern of sensory loss -
1 division = peripheral nerve lesion
>1 division = Root/BS lesion
"­onion skin" = BS lesion

Type of sensory loss
Dissoc­iated sensory loss (pain + temper­ature affected, touch preserved) = BS lesion

Presence of limb motor &/or sensory signs? =
Yes + with cranial nerve palsies = intrinsic BS lesion
Yes + without CN palsies = suprat­ent­ori­al/­upper cx lesion

Conditions

Vascular - ischaemia (dorsa­l/l­ateral area)
Neoplastic - benign­/ma­lignant
Demyel­ination - MS
Syring­obulbia
Acoustic Neuroma
Trigeminal neuroma
Meningitis
Petros­itosis (infla­mmation of petrous part of temporal bone)- otitis media, osteit­is/­men­ingitis - VI affected too
Skull base
Nasoph­arygeal cancer­/Mets
Cavernous sinus
Involv­ement of IV, VI, + V1
 
- Tumour, intrac­ave­rnous aneurysm, cavernous sinus thrombosis (oedema + pain in the eye +ICP), Tolosa Hunt syndrome

Conditions affecting VII

Bells Palsy: at stylom­astoid foramen
Ramsay Hunt at geniculate ganglion
Hemifacial Spasm at exit from BS

Localising Concepts

Unilateral involv­ement of the lower face
Contra­lateral supran­uclear lesion (UMNL) - Vascular, Tumour, Demyel­ina­tion, Infection
Unilateral involv­ement of the upper and lower face + contra­lateral eye closure
Ipsila­teral nuclea­r/i­nfr­anu­clear lesion

Peripheral Nerve Lesion

S&S
Causes
Unilateral weaknesss
Parotid gland lesion
Usually localised to specific muscle group
Parotid operations
 
Facial Trauma
 
Haematoma

Facial Canal

S&S
Causes
Unilat­eral, complete facial weakness
F# of skull base
Loss of taste +saliv­ation
Spread of middle ear infection
 
Bell's palsy - most common
 
Leukaemic deposits

Internal Auditory Meatus

S&S
Causes
Ramsey Hunt Syndrome:
Herpes Zoster of CN VII + Chorda Tympani
Vesicular rash on external ear
LMNL paralysis of facial nerve
Loss of taste sensation over anterior 2/3 of tongue

Acoustic tumour­s/m­eni­ngi­oma

S&S
V,VIII (IX, X, XI) palsy
Loss of taste, salivation & lacrim­ation
Hypera­cusis

Wallenberg syndrome

S&S
Causes
Long tract signs
Dorsal BS lesion @ level of pons - Vascul­ar/­isc­haemic in origin (PICA)
Ipsila­teral LMNL to face
Demyel­ination
Ipsila­teral VI palsy
MND
Ipsila­teral loss of pain & Temp of face
Syring­obulbia
Contra­lateral decrease in touch, position and vibration
Tumour
Contra­lateral decrease in pain and temper­ature in limbs