Wednesday, May 18, 2011

Oculomotor nerve palsy - Clinical

Incomplete Paralysis of the common oculomotorului are more frequent than total paralysis.
Effects of muscle paralysis on eye movements are:- Limitation of eye movements in the direction of muscle paralysis- Paralytic strabismus - when the patient tries to look in the direction of muscle paralysis, the affected eye remains immobile or move very little, while the eye moves normally healthy- Diplopia - double images are seen by the patient. To correct the diplopia, the patient adopt a certain position of the head.
Common oculomotor nerve palsy is manifested by the following symptoms:- Upper eyelid ptosis (eyelid lift failure). The patient tries to adjust crinkled forehead and head back giving- Is external strabismus, diverging, the muscle action as external.- Affected eye can not make any movement, but towards outside and down.- When the third nerve paralysis not associated with ptosis, the compensating attitude of the head is towards the healthy.- Diplopia is present only when the upper lid is lifted or when no ptosis, so when the patient looks with both eyes. Diplopia is heteronima.- When they are caught and threads of the parasympathetic component of autonomic nerve III occurs and paralytic mydriasis.
Trohlear nerve paralysis is less common than nerve III. Diplopia occurs when the patient looks down. Eyeball can be moved in the directions below and externally. The patient's head back toward normal eyeball slightly bent and shoulder of the affected eye.
Abducens nerve palsy is the most common muscle paralysis affecting the eye, because the nerve is more vulnerable to others.The vulnerability occurs in the nerve from the fact that it has the longest paths and subarachnoid and is thinnest cranial nerve. VI nerve innervating the muscle as external. After paralysis of the muscles is a convergent strabismus with diplopia homonymous with limited eye movements towards outside. The patient tends to turn the head of the affected eye.

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