![]() Visual acuity, afferent pupillary response A physician should approach the examination in a systematic fashion and go through the cranial nerves in their numerical order. The cranial nerves are symmetrical therefore, while performing the examination, the examiner should compare each side to the other. The cranial nerve examination is applied neuroanatomy. Importantly, a variety of pathological conditions that are associated with alterations in mental status (such as some neurodegenerative disorders or brain lesions) can also cause cranial nerve dysfunction therefore, any abnormal findings during a mental status exam should prompt a careful and complete neurological exam. However, in many cases a patient's history doesn't directly suggest cranial nerve pathologies, as some of them (such as sixth nerve palsy) may have subtle manifestations and can only be uncovered by a careful neurological exam. In some cases, cranial nerve dysfunction is readily apparent: a patient might mention a characteristic chief complaint (such as loss of smell or diplopia), or a visually evident physical sign of cranial nerve involvement, such as in facial nerve palsy. ![]() Kaplan, MD Neurology, Brigham and Women's/Massachusetts General Hospital, Boston, Massachusetts, USAĭuring each section of the neurological testing, the examiner uses the powers of observation to assess the patient. ![]()
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