Neurology

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Sudden Hearing Loss

By Dr Peter Kas | 12/02/2021

A 64 year old male is sent into the Emergency Department by an audiologist with...

Risk Stratification of Sudden Headache

By Dr Peter Kas | 12/12/2020

This week we try something different. I interview the lead author of a recent paper...

Idiopathic Intracranial Hypertension

By Dr Peter Kas | 04/12/2020

A 28 year old woman presents to the emergency department with one week of headaches....

Source: September 2006Comprehensive ophthalmology update 7(5):215-21; discussion 223-4

Can you diagnose the cause of DIPLOPIA? Take the test.

By Dr Peter Kas | 07/11/2020

334

Created by

Dr Peter Kas

Can you Diagnose the Cause of DIPLOPIA?

A 58 yo male presents to the emergency department with a complaint of "Doc I'm seeing double"
Try these 8 questions.

1 / 8

If you think that the patient has MONOCULAR DIPLOPIA

The diplopia resolves when one eye is closed or covered.

It is due to Ocular Misalignment

It is most commonly due to a refraction error

It requires investigation with a non-contrast CT scan

All of the above are true

2 / 8

In terms of BINOCULAR DIPLOPIA, which of the following is correct?

It resolves when one eye is closed or covered

It indicates ocular misalignment

It may be due to Thyroid Orbitopathy

It may be due to neuromuscular junction pathology, such as myasthenia graves

All of the above are true

3 / 8

Which cranial nerve is affected here?

Source: October 2011Case Reports in Neurology 3(3):248-51

Left CN III

Right CN III

Right CN IV

Left CN VI

CN VII

4 / 8

Which cranial nerve is affected here?

Source: September 2006Comprehensive ophthalmology update 7(5):215-21; discussion 223-4

CN II

CN III

CN IV

CN VI

CN VII

5 / 8

Look at the following image. Which Cranial Nerve is involved?

Source: Oman J Ophthalmol. 2014 May-Aug; 7(2): 103–104

CN III

CN IV

CN VI

CN VII

CN II

6 / 8

In the following image, when would you expect diplopia to occur?

Source: September 2006Comprehensive ophthalmology update 7(5):215-21; discussion 223-4

When the patient's looks to his right

When the patient looks to his left

When the patient looks upward

When the patient looks downward

When the patient looks in any direction

7 / 8

Multiple cranial nerve abnormalities and any headache require an urgent CT brain looking for:( 2 correct answers)

Cavernous Sinus Lesion

Orbital Apex Lesion

Extradural Heamorrhage

Subdural Haemorrhage

Subarachnoid Haemorrhage

8 / 8

Cranial Nerve III paralysis can be complete or incomplete.
In terms of clinical findings in CN III paralysis, which of the following is true?(3 correct answers)

There is Mydriasis

There is Ptosis

Anisocoria is isolated

The pupil is down and out

There is Exophthalmos

Your score is

The average score is 50%

Read the Blog on Diplopia.

Bell’s Palsy

By Dr Peter Kas | 17/09/2020

What is Bell's Palsy? It is an ipsilateral Cranial Nerve VII (lower motor neurone) palsy. There...

Trigeminal Neuralgia

By Dr Peter Kas | 12/09/2020

An excellent review article on Trigeminal Neuralgia, has just come out in the NEJM(1). Here...

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Status Epilepticus: Get the Ketamine

A/Prof Peter Kas looks at the status and refractory as well as super refractory status…

Not SAH: Are We Done?

A/Prof Peter Kas looks at the patient who has presented with sudden onset of headache…

BP Control in Intracerebral Bleeds

A/Prof Peter Kas looks at the topic, of how tightly we must control the blood…

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Head injury and blood thinners-When to Scan

By Dr Peter Kas | 29/11/2012

The Relative Afferent Pupillary Defect

By Dr Peter Kas | 13/11/2011

Doll’s Eyes and Brainstem Stroke

By Dr Peter Kas | 18/02/2012

The Patient with Diplopia

By Dr Peter Kas | 14/01/2019

Neurology

Sudden Hearing Loss

Risk Stratification of Sudden Headache

Idiopathic Intracranial Hypertension

Can you diagnose the cause of DIPLOPIA? Take the test.

Bell’s Palsy

Trigeminal Neuralgia

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Featured Posts:

Status Epilepticus: Get the Ketamine

Not SAH: Are We Done?

BP Control in Intracerebral Bleeds

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Head injury and blood thinners-When to Scan

The Relative Afferent Pupillary Defect

Doll’s Eyes and Brainstem Stroke

The Patient with Diplopia

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