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If you can't elicit the corneal reflex, look for other signs of trigeminal nerve dysfunction. To test the three sensory portions of the nerve, touch each side of the patient's face on the brow, cheek, and jaw with a cotton wisp, and ask him to compare the sensations.
If you suspect facial nerve involvement, note if the upper face (brow and eyes) and lower face (cheek, mouth, and chin) are weak bilaterally. Lower motor neuron facial weakness affects the face on the same side as the lesion, whereas upper motor neuron weakness affects the side opposite the lesion — predominantly the lower facial muscles.
Because an absent corneal reflex may signify such progressive neurologic disorders as Guillain-Barré syndrome, ask the patient about associated symptoms — facial pain, dysphagia, and limb weakness.
Source: Handbook of Signs & Symptoms (Third Edition), 2006
If you can’t elicit the corneal reflex, look for other signs of trigeminal nerve dysfunction. To test the three sensory portions of the nerve, touch each side of the patient’s face on the brow, cheek, and jaw with a cotton wisp, and ask him to compare the sensations.
If you suspect facial nerve involvement, determine whether both the upper face (brow and eyes) and lower face (cheek, mouth, and chin) are weak bilaterally. Lower-motor-neuron facial weakness affects the face on the same side as the lesion, whereas upper-motor-neuron weakness affects the side opposite the lesion—predominantly the lower facial muscles.
Because an absent corneal reflex may signify such progressive neurologic disorders as Guillain-Barré syndrome, ask the patient about associated symptoms, such as facial pain, dysphagia, and limb weakness.
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
After detecting an absent doll’s eye sign, perform a neurologic examination. First, evaluate the patient’s level of consciousness (LOC), using the Glasgow Coma Scale. Note decerebrate or decorticate posture. Examine the pupils for size, equality, and response to light. Check for signs of increased ICP—increased systolic blood pressure, widening pulse pressure, and bradycardia.
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
If you can't elicit the corneal reflex, look for other signs of trigeminal nerve dysfunction. To test the three sensory portions of the nerve, touch each side of the patient's face on the brow, cheek, and jaw with a cotton wisp, and ask him to compare the sensations.
If you suspect facial nerve involvement, note if the upper face (brow and eyes) and lower face (cheek, mouth, and chin) are weak bilaterally. Lower motor neuron facial weakness affects the face on the same side as the lesion, whereas upper motor neuron weakness affects the side opposite the lesion—predominantly the lower facial muscles.
Because an absent corneal reflex may signify such progressive neurologic disorders as Guillain-Barré syndrome, ask the patient about associated symptoms—facial pain, dysphagia, and limb weakness.
Source: Nursing: Interpreting Signs and Symptoms, 2007
After detecting an absent doll's eye sign, perform a neurologic examination. First, evaluate the patient's level of consciousness, using the Glasgow Coma Scale. Note decerebrate or decorticate posture. Examine the pupils for size, equality, and response to light. Check for signs of increased ICP—increased blood pressure, increasing pulse pressure, and bradycardia.
Source: Nursing: Interpreting Signs and Symptoms, 2007
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