The Clinical Problem Solvers Episode 199: Neurology VMR – Diplopia
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Oct 6, 2021 Dr. Aaron Berkowitz, known for his efforts to #EndNeurophobia, explores the intricate world of diplopia alongside medical students Gabriela Pucci, Gabriel Talledo, and Valeria Roldan. They dissect the causes and classifications of double vision, emphasizing the role of cranial nerves and brain structures. Interesting case studies illuminate diagnostic approaches and the significance of thorough clinical examinations. The group dives into cranial nerve six and third cranial nerve pathologies, unraveling complexities and sharing invaluable insights for future neurologists.
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Understanding Diplopia Types
- Diplopia arises from eye misalignment causing image disparity on retinas.
- Binocular diplopia resolves when one eye is covered; monocular usually relates to lens or retinal issues.
Eye Movement Control Pathways
- Six extraocular muscles are controlled by cranial nerves 3, 4, and 6.
- Coordination for conjugate gaze involves the medial longitudinal fasciculus for communication between cranial nerve nuclei.
Frontal Eye Field Controls Gaze
- Looking left involves activating right frontal eye field which signals left PPRF, left CN 6, and right CN 3 for conjugate gaze.
- The frontal eye field controls eyes opposite its hemisphere to permit coordinated horizontal movements.
