Cranial Nerve XI: the Spinal Accessory Nerve Cranial nerve (CN) XI, or the spinal accessory nerve (SAN), serves primarily as the motor nerve for the sternocleidomastoid (SCM) and trapezius muscles in the neck and shoulder. It has an intriguing functional…
Cranial Nerve IX: Glossopharyngeal Nerve and Swallowing The glossopharyngeal nerve is a mixed nerve, containing both sensory and motor fibers along with parasympathetic, special sensory, and visceral sensory components. The motor component is fibers to the stylopharyngeus muscle, as well…
Auditory Nerve Clinical Vignette A 68-year-old man presented with sudden onset of unilateral right-sided hearing loss. He stated that this was preceded by several months of constant ringing in his right ear. He had a history of hypertension and type…
Clinical Vignette A 62-year-old judge became aware of subtle weakness of his left lower face that he first noted while shaving. Two months later, he noted that he could no longer close his left eyelid fully and was having increasing…
Clinical Vignette A 58-year-old retired town clerk presented with a 2-week history of numbness over her left chin and adjacent lower lip as well as vague pain in the left jaw. She explained that the area feels “Novacaine-like,” exactly like…
Cranial Nerve III: Oculomotor Clinical Vignette A 37-year-old woman presented with a 2-day history of “blurry” vision on upward gaze and headache. One month previously, when she had experienced the same symptoms, sinusitis was diagnosed, and an antibiotic was prescribed;…
Intraocular Optic Nerve Clinical Vignette A 48-year-old man was referred for sudden loss of vision in the left eye. He had noted that morning while shaving that he could not see the lower half of his chin with the right…
Clinical Vignette A 64-year-old woman, a retired music teacher and a food and wine connoisseur, was driving to the airport to catch a flight to Spain when she noted she could not smell the characteristic skunk odor her friend was…
The armamentarium of neuroimaging techniques includes: computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, x-ray, fluoroscopy, and nuclear medicine (NM). Of these, CT and MRI have found the most use in daily practice and are frequently used as first-line neuroimaging,…
Clinical Vignette A 45-year-old woman presents to clinic with episodic left-sided weakness, dysarthria, and gait imbalance. The first episode occurred 9 months ago upon awakening and resolved gradually over 2 days. She had no associated headache, visual symptoms, or nausea.…