51. Sixth Nerve Disease

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Identifier 51_Sixth_Nerve_Disease.mp3
Title 51. Sixth Nerve Disease
Creator J. Lawton Smith, Professor Emeritus of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine
Subject Abducens palsy, sixth cranial nerve palsy, pons, parapontine reticular formation (PPRF), seventh cranial nerve, internuclear ophthalmoplegia, horizontal gaze palsy, facial colliculus, Dorello's canal, Gruber's ligament, thyroid eye disease, spasm of near reflex, old squint, Duane syndrome, Horner syndrome, acoustic neuroma, pseudotumor cerebri, intracavernous carotid aneursym, anterior inferior cerebellar artery syndrome, superior orbital fissure, carotid cavernous fistula, diabetic ophthalmoplegia, horizontal diplopia; Sixth (Abducens)
History In August of 1975 J Lawton Smith describes eight anatomical subtypes of 6th cranial nerve palsy. He also goes over the anatomical course of the 6th nerve and various disease processes that affect the 6th nerve at different anatomical locations.
Clinical Forced duction test for thyroid eye disease. Pupils constrict when the patient is asked to look to one side, the eye does not abduct in the spasm of near reflex. Anisometropia will be seen in old squints.The globe retracts when the patient tries to adduct in Duane syndrome.
Neuroimaging Head x-ray, orbital venography with substraction to demonstrate cavernous sinus lesion
Anatomy J. Lawton Smith describes the course of the 6th nerve originating from the abducens nucleus in pons and subsequently talks about 6th nerve course in proximity with the pontomedullary junction. Running in proximity with the pre-pontine cistern close to apex of the temporal bone, through the cavernous sinus in proximity with the Gruber???s ligament into the superior orbital fissure and then residing in the orbit supplying the lateral rectus muscle. He talks about origins of all the cranial nerves from the brainstem.
Pathology Depends on the anatomical site at which sixth nerve is affected. Pontine lesion, pontine infarct, abducens or cranial nerve lesion, meningitis, fracture of the base of the skull, increased intracranial pressure
Disease/Diagnosis Abducens or 6th cranial nerve palsy; pontine infarct; anterior and inferior cerebellar artery syndrome; Internuclear ophthalmoplegia; Differential diagnosis: a. Old squint. b. Duane syndrome. c. Thyroid eye disease. d. Spasm of near reflex. e. Entrapment syndrome f. Secondary fibrosis of the medial rectus. g. Diabetic ophthalmoplegia.
Relation is Part of J. Lawton Smith Collection
Contributor Primary J. Lawton Smith, Professor Emeritus of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Date 1975-08-06
Type Sound
Format audio/mpeg
Format Creation Filesize: 100,892,729 bytes; Play length: 53:57; Jeremy Smith, audio technician; Tandberg TB15 Reel-to-reel deck; 16 bit mono; Captured using SAWstudio; Encoded using LAME; Windows 2000
Source 1/4" reel-to-reel audio tape
Rights Management Copyright 2002. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
Holding Institution North American Neuro-Ophthalmology Association. NANOS Executive Office 324 North Main Street West Hartford, CT 06117-2507
Collection Neuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
Language eng
ARK ark:/87278/s6k64kr8
Setname ehsl_novel_jls
Date Created 2006-08-08
Date Modified 2021-05-06
ID 180225
Reference URL https://collections.lib.utah.edu/ark:/87278/s6k64kr8