NEURO CONSULT — r20261009s-9SERIES: THE CASTTHE LOCALIZER
STAT

Cranial nerves, ranked by how impressive it looks when you find the problem. Twelfth: a tongue that drifts to one side. Quiet. Devastating. Sixth: an eye that will not turn outward. Dramatic. Localises to almost nothing. Third: a pupil that has blown. Everyone in the room stops talking. First: I have never once tested it. Which one have you actually said out loud? Save this and send it to whoever is revising for finals.

EXPLAINED (ACCURACY-CHECKED)

Hypoglossal (XII) lesions cause the tongue to deviate toward the side of the lesion; abducens (VI) palsy impairs eye abduction and is classically a poor localiser because the long intracranial course makes it a false localising sign in raised intracranial pressure; a pupil-involving third nerve palsy is a recognised emergency; olfactory (I) testing is routinely omitted from the standard bedside examination.

Established neuroanatomy: XII deviation toward lesion; VI as classic false localising sign; pupil-involving III as emergency; CN I routinely untested.
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