05-22-2008, 09:02 AM
The answer is E.
Bilateral conjugate eye movement to the side of the caloric stimulation indicates integrity of
the brainstem pathways from the medulla to the midbrain (where the third nerve originates),
as do full conjugate oculocephalic motions (doll™s-eye maneuvers). The absence of the rapid
corrective phase manifested by nystagmus-like leftward gazing indicates a bilateral
hemispheric lesion. Failure of an eye to adduct properly in the initial phase of the caloric
response indicates a lesion in the ipsilateral third nerve (midbrain) or in the medial
longitudinal fasciculus producing internuclear ophthalmoplegia. In the former case, the pupil
would be dilated and the eye would be abducted at rest.
Bilateral conjugate eye movement to the side of the caloric stimulation indicates integrity of
the brainstem pathways from the medulla to the midbrain (where the third nerve originates),
as do full conjugate oculocephalic motions (doll™s-eye maneuvers). The absence of the rapid
corrective phase manifested by nystagmus-like leftward gazing indicates a bilateral
hemispheric lesion. Failure of an eye to adduct properly in the initial phase of the caloric
response indicates a lesion in the ipsilateral third nerve (midbrain) or in the medial
longitudinal fasciculus producing internuclear ophthalmoplegia. In the former case, the pupil
would be dilated and the eye would be abducted at rest.