Phys · general-medicine
Neurological Examination — Cranial Nerves
Also known as cranial nerve examination · CN I-XII examination · cranial nerves · neurological short case · cranial nerve palsies · third nerve palsy · oculomotor palsy · facial nerve palsy · Bell palsy · Horner syndrome · relative afferent pupillary defect · RAPD · Rinne and Weber · pupil-sparing third nerve palsy
Classic DCE short-case routine for cranial nerve examination (CN I to XII): the systematic sequence, the signs to elicit, their localising value, a say-aloud presentation template, examiner discussion questions and the pitfalls that fail candidates — for FRACP DCE, MRCP PACES and ABIM preparation.
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Neurological Examination — Cranial Nerves
Meet the patient
The instruction is "Please examine this patient's cranial nerves." Before you touch the patient, watch from the foot of the bed. A ptosis, a flattened nasolabial fold, a compensatory head tilt, temporalis wasting — each betrays a nerve lesion before a single reflex is tested.[1]
Set the stage: patient seated at your eye level, a Snellen chart, a pin, a cotton wisp, a 512 Hz tuning fork, an ophthalmoscope, a reflex hammer. State your plan aloud, then proceed nerve by nerve, never breaking sequence to chase a sign.[1]
You have read the opening of this topic. The complete unit — every section and its primary-source references — is part of the Physician Medicine fellowship atlas.
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- [1]Sullivan FM, Swan IR, Donnan PT, et al. Early treatment with prednisolone or acyclovir in Bell's palsy N Engl J Med, 2007.PMID 17942873
- [2]Madhok VB, Gagyor I, Daly F, et al. Corticosteroids for Bell's palsy (idiopathic facial paralysis) Cochrane Database Syst Rev, 2016.PMID 27428352
- [3]Gagyor I, Madhok VB, Daly F, Sullivan F Antiviral treatment for Bell's palsy (idiopathic facial paralysis) Cochrane Database Syst Rev, 2019.PMID 31486071
- [4]Sadaka A, Schockman SL, Golnik KC Evaluation of Horner Syndrome in the MRI Era J Neuroophthalmol, 2017.PMID 28445191
- [5]Chang DS, Xu L, Boland MV, Friedman DS Accuracy of pupil assessment for the detection of glaucoma: a systematic review and meta-analysis Ophthalmology, 2013.PMID 23809274