Joined
·
753 Posts
is the lesion at D? bcs in the clinical vignette, pt exhibits c/f s/o 6th nv palsy (being unable to look to the left and c/o diplopia) and 7th nerve palsy (facial weakness). so the only answer i think is logical in this case, is at the facial colliculus namely D.45 year old male presented with headache and double vision. On examination you noticed that the patient is unable to look to the left in both eyes. Some facial muscle weakness also noted. Which of the following labeled structures is the most likely site of the lesion.
View attachment 374
The control of conjugate gaze is mediated in the brainstem by the medial longitudinal fasciculus (MLF), a nerve tract that connects the three extraocular motor nuclei (abducens, trochlear and oculomotor) into a single functional unit. Lesions of the abducens nucleus and the MLF produce observable sixth nerve problems, most notably internuclear ophthalmoplegia (INO).BUT D in this diagram is the sixth nerve nuclei and then how can it be a MLF lesion????:notsure:
Does that mean Abducens ,trochlea or oculomotor lesion will present same as a MLF lesion with internuclear ophthamoplegia?The control of conjugate gaze is mediated in the brainstem by the medial longitudinal fasciculus (MLF), a nerve tract that connects the three extraocular motor nuclei (abducens, trochlear and oculomotor) into a single functional unit. Lesions of the abducens nucleus and the MLF produce observable sixth nerve problems, most notably internuclear ophthalmoplegia (INO).
-