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==Physical Examination==
==Physical Examination==
===Neurologic===
* Most common signs includs:
:* [[Cranial nerve]] deficit
::* Sixth and seventh cranial nerves are involved commonly
:* [[Pyramidal tract]] signs
:* [[ataxia]]


Common clinical findings can be summarized as constituting a triad of [[cranial nerve deficit]]s, long tract signs, and [[ataxia]] (of trunk and limbs). [[Papilledema]] may be seen.
* For tectal lesions, more common signs includs:
:*[[diplopia]]
:*[[ophthalmoplegia]]
:*[[Parinaud syndrome]]
:*[[accommodation]]  
:*[[light-near dissociation]]


Sixth and seventh cranial nerves are involved commonly. Facial [[sensory loss]] and a [[primary position]], upbeating [[nystagmus]] may be seen. Involvement of cranial nerve III or IV suggests a mesencephalic component.
* For cervicomedullary lesions, more common signs includs:
:* [[sensory loss]] of the face
:* [[dysphagia]]


Tectal lesions may present with [[diplopia]] reflecting an internuclear [[ophthalmoplegia]], indicating involvement of the [[medial longitudinal fasciculus]]. [[Parinaud syndrome]] also may be seen, with paralysis of upward gaze and [[accommodation]], [[light-near dissociation]] (loss of pupillary reflex to light with preservation of pupilloconstriction in response to convergence), [[eyelid retraction]], and convergence-retraction nystagmus.
:* [[dysphonia]]
 
Cervicomedullary lesions may present with [[sensory loss]] of the face (involvement of the trigeminal nucleus), [[dysphagia]] and/or [[dysphonia]] from lower cranial nerve involvement (commonly IX and X), long tract signs, and [[ataxia]]. Downbeating nystagmus and [[oculomyoclonus]] often are seen with medullary involvement.


==References==
==References==

Revision as of 19:28, 20 August 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Physical Examination

Neurologic

  • Most common signs includs:
  • Sixth and seventh cranial nerves are involved commonly
  • For tectal lesions, more common signs includs:
  • For cervicomedullary lesions, more common signs includs:

References

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