Cranial Nerve 6 – Abducens Nerve

 

@   GSE

@   Abducens Nerve Þ 是腦神經中最易受傷者。

 

@   Abducens nucleus Þ 是腦神經運動核中唯一含有兩種運動神經元者。一為典型的Motor neurons,行經Abducens nerve,去支配同側的Lateral rectus muscle。另一為Internuclear neurons,行經對側的Medial longitudinal faciculus (MLF),去支配對側的Medial rectus muscle

 

@   功能 Þ 外展眼睛。所以當Abducens nerve受傷時,會造成Medial strabismus (內斜視)Horizontal diplopia (水平複視)(A paresis or paralysis of ocular adduction on attempted lateral gaze to the opposite side)

1.     Lesion of right abducens nerve Þ 當意欲向右凝視時,造成Right lateral rectus palsy (類似鬥雞眼)

2.     Lesion of right abducens nucleus Þ 當意欲向右凝視時,兩眼均偏向左側並有Diplopia現象,造成Right lateral gaze paralysis (類似向左凝視)

3.     Lesion in right MLF Þ 當意欲向左凝視時,右眼的內收麻痺,左眼有Horizontal nystagmus現象,但兩眼的Convergence則正常。造成所謂的Right MLF syndrome Right internuclear ophthalmoplegia (核間性眼肌癱瘓)

4.     Middle alternating hemiplegia Þ Roots fibers of the abducens nerve may be concomitantly destroyed along with fibers of the corticospinal tract in the caudal pons as a consequence of a vascular lesion. It is characterized by an ipsilateral lateral rectus paralysis and a contralateral hemiplegia.

 

@   Functional Components of the Abducens Nerve

1.     GSE To Lateral rectus muscle

2.     GSA (possible) Proprioceptive fibers from the lateral rectus muscle ® Communicating branch (in the cavernous sinus) with the trigeminal nerve ® Mesencephalic nucleus