英文神经病学重点整理.docxVIP

CNⅠ: Olfactory Nerve (嗅神经)Foster-Kennedy syndrome: Frontal lobe tumors cause optic atrophy on the side of the tumor, papilledema smell on the opposite side.见于额叶底部肿瘤，表现为病变侧因肿瘤压迫而视神经萎缩，病变对侧因高颅压而视乳头水肿和嗅觉减退Optic Nerve (视神经)Clinical Correlation视力障碍视野缺损Optic nerve -Ipsilateral visual loss(同侧全盲)Optic chiasm - Bitemporal hemianopsia (双颞侧偏盲)Optic tract - Contralateral incongruous homonymous hemianopsia (对侧视野同向偏盲)Optic radiations - Quadrantic field defect(象限盲) 1.视辐射全损坏：对侧视野同向偏盲 2.视辐射下部损害(颞叶)：对侧视野同向上象限盲 3.视辐射上部损害(顶叶)：对侧视野同向下象限盲Occiptal lobe - cortical blindness/Contralateral congruous homonymous hemianopia 对侧视野同向偏盲,对光反射存在 macular sparing黄斑回避Oculomotor Nerve/III (动眼神经)外侧核：上睑提肌上直肌（上内）/下直肌（下内）/内直肌（内）/下斜肌（上外）正中核：内直肌（辐辏运动）E-W核：瞳孔括约肌睫状肌（缩瞳调节反射）Complete damage symptoms：上睑下垂Ptosis外下斜视/分离性斜视Divergent strabismus瞳孔散大Dilated pupil调节反射对光反射消失Loss of light and accommodation reflex复视DiplopiaTrochlear Nerve / IV (滑车神经)上斜肌：下外Abducens paralysis/ VI (外展神经)外直肌：外Internuclear ophthalmoplegia核间性麻痹/medial longitudinal fasciculus syndrome内侧纵束综合征Reflects disconnection of the oculomotor nucleus from the contralateral lateral gaze centreWhen attempting to look the contralateral side, Ipsilateral eye fails to adduct, contralateral eye abduct with nystagmus, convengence reflex is normal.脑桥侧视中枢动眼神经核之间内侧纵束上行纤维病变患侧眼不能内收，对侧眼球外展伴有眼震，辐辏反射正常2.后核间性眼肌麻痹脑桥侧视中枢外展神经核之间内侧纵束下行纤维病变患侧眼不能外展，对侧眼球内收正常(伴有眼震?)，辐辏反射正常3.一个半综合征one and a half syndrome一侧脑桥侧视中枢对侧交叉来的内侧纵束同时受累患侧眼球不能内收外展，对侧眼球不能内收，外展时伴有眼震Uppernuclear ophthalmoplegia核上性麻痹1.侧向凝视麻痹1)皮质侧视中枢（额中回后部）受损，双眼向病灶侧共同偏视Lobe gaze centre injure, fail to attempting to look the contralateral side. 2)皮质下侧视中枢（脑桥）受损，双眼向病灶对侧共同偏视2.垂直凝视麻痹 皮质下垂直同向运动中枢（上丘-上半司向上运动，下半司向下运动）受损，双眼垂直运动障碍；核上性麻痹共同特点: No Diplopia 无复视two eyes involved双眼同时受累;reflex movement exist麻痹性眼肌的反射性运动仍保存(不能随意向一侧运动,但声响可产生转向该侧的反射活动)Horner’s syndromeThe descending sympathetic tract由颈上交感神经径路损害所致Lesions result in ipsilateral病变同侧: 1.miosis / Small pupil瞳孔缩小2.mild ptosis眼睑下垂3.hemi-anhidrosis / loss of sweating in lesion side损面无汗4.apparen