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Old 06-19-2014
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Default Neuro Question

Hi guys, I got this q in one of the banks& I dnt understand it. help?

A 68-year-old woman suffered from an infectious disorder for several weeks. Following recovery from this disorder, she experienced some loss of taste and an increase in salivation, together with painful spasms in the region of the pharynx, which extended into the ear. She also experienced some bradycardia and cardiac arrhythmia, as well as deviation of the uvula to the unaffected side. Which of the following sites is the most likely locus of the lesion affecting this nerve?

A. Upper medulla
B. Lower medulla
C. Lower pons
D. Upper pons
E. Base of the skull
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Old 06-19-2014
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The explanation says its E. but WHY NOT A?

EXPLANATION: When the glossopharyngeal nerve is affected by an infectious agent, it results in the inability to move the right eye to the right (ie, in a lateral direction). Since the cell bodies of motor (or visceral motor) fibers (mediating motor and visceral effects) as well as the terminals of sensory afferents (mediating pain from the pharynx) lie in different regions of the medulla, it is very unlikely that such an effect could be the result of damage within the brainstem. A much more likely occurrence is that the infectious agent produced disruption of the glossopharyngeal nerve peripherally, such as at the base of the skull or jugular foramen, where all the components run together and can be more easily affected.
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