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It can also be used to diagnose the cause of vertigo, dizziness or balance dysfunction by testing the vestibular system. [1] Electronystagmography is used to assess voluntary and involuntary eye movements. [2] It evaluates the cochlear nerve and the oculomotor nerve (CN III). [2] The ENG can be used to determine the origin of various eye and ...
Videonystagmography (VNG) is a type of testing used to assess vestibular and central nervous system function through the use of eye movement tracking, specifically evaluating nystagmus. [1] The older version of technology used to perform these tests, known as electronystagmography (ENG), leverages electrophysiological signals.
Unilateral loss indicates a possible nerve lesion or deviated septum. This test is usually skipped on a cranial nerve exam. [1] The short axons of the first cranial nerve regenerate on a regular basis. The neurons in the olfactory epithelium have a limited life span, and new cells grow to replace the ones that die off.
Another nerve tract projects from the abducens nucleus by the medial longitudinal fasciculus to the oculomotor nucleus of the opposite side, which contains motor neurons that drive eye muscle activity, specifically activating the medial rectus muscle of the eye through the oculomotor nerve.
When the optic nerve is damaged, the sensory (afferent) stimulus sent to the midbrain is reduced. The pupil, responding less vigorously, dilates from its prior constricted state when the light is moved away from the unaffected eye and towards the affected eye. This response is a relative afferent pupillary defect (or Marcus Gunn pupil). [1]
Diagram illustrating the locations of extraocular muscles and ocular cranial nerves. Paresis of the oculomotor nerve (CNIII) reduces the strength of medial rectus, superior rectus, inferior rectus, and inferior oblique muscles, while trochlear nerve (CNIV) and abducens nerve (CNVI) paralysis affect superior oblique muscle and lateral rectus muscle respectively.
Emergency physicians routinely test pupillary light reflex to assess brain stem function. Abnormal pupillary reflex can be found in optic nerve injury, oculomotor nerve damage, brain stem lesion (including brain stem death), and depressant drugs, such as barbiturates. [5] [6] Examples are provided as below:
Light from a single point of a distant object and light from a single point of a near object being brought to a focus. The accommodation reflex (or accommodation-convergence reflex) is a reflex action of the eye, in response to focusing on a near object, then looking at a distant object (and vice versa), comprising coordinated changes in vergence, lens shape (accommodation) and pupil size.