Disorders of the Cranial Nerves

Disorders of the cranial nerves are some of the most common disorders seen by neurologists. They range from the relatively straightforward isolated sixth nerve palsy to complex multiple cranial neuropathies that may be focal, as in the jugular foramen syndrome, to diffuse as in carcinomatous meningitis. This issue of Seminars in Neurology is devoted to disorders of the cranial nerves. Each chapter includes a brief review of the pertinent neuroanatomy, which is always helpful in recalling the anatomic details that may be helpful in localization.

Chapter 1 covers the facial nerve. It was written by longtime colleague and former Fellow, Jim Gilchrist, of Brown University and the Rhode Island Hospital. I first met Jim when he was a senior resident and I was a junior attending at the Medical College of Virginia. I think he probably knew more neurology than I did.

Chapter 2 is an erudite discussion of the extraocular nerves by Neuro-ophthalmologist Extraordinaire Dr. Paul Brazis of the Mayo Clinic Jacksonville. Dr. Brazis is one of the co-authors of the very popular book Localization in Clinical Neurology.

Chapter 3 covers the optic nerve. It is written by longtime colleague Jack Selhorst. I first met Jack when he was a Neuroophthalmology Fellow and I was a rotating resident at the University of California San Francisco, studying under the legendary William F. Hoyt, a truly unforgettable experience. Later, we were both on the faculty at the Medical College of Virginia. Jack's rising star soon took him to the Chairmanship at St. Louis University while I labored for many years in the vineyard at MCV. It was a pleasure to rejoin forces with Dr. Selhorst and his colleague for this issue of Seminars.

Chapter 4 is a discussion of the trigeminal nerve, senior authored by Dr. Yuen T. So, a battle-scarred colleague from many years of committee work for the American Association of Neuromuscular and Electrodiagnostic Medicine. Over that time I grew to appreciate his intelligence and reliability and was quick to ask him to participate in this project.

Chapter 5 is a discussion of the hypoglossal nerve, senior authored by Dr. Paul Barkhaus, whose expertise in all things neurologic I grew to appreciate as we worked together on the examination committee of the American Board of Electrodiagnostic Medicine.

Chapter 6 was written in collaboration with a recent graduate of our Walter Reed Clinical Neurophysiology Fellowship Program who is now on the staff at Portsmouth Naval Hospital. Dr. Carroll is a bright young man with a strong work ethic who will do well in Neurology in the years ahead.

Chapter 7 was written by two former Walter Reed Fellows, Dr. Mark Landau and Dr. Kristen Barner, who are now staff clinical neurophysiologists; Fellowship, like Lubbock, Texas, only a faint image in their rear view mirrors. World events have provided an unfortunate opportunity to mature clinically at a rapid rate at the military's busiest hospital.

Chapter 9 was written by Dr. Wayne Massey, who began a career of profuse medical writing while on the staff at Bethesda Naval Hospital. It seems to have begun about the time of the Battle of Dunkirk, but it was only in the 1970s. Much of his writing has been about mononeuropathies. It seems life has come full circle because I now frequently see patients at Bethesda Naval and staff a weekly peripheral nerve clinic there.

To prove that one does not have to be either a neurologist or even a physician to be an expert regarding a cranial nerve disorder, we are joined by Drs. Audrey Erman and Dr. Richard Doty. Audrey B. Erman, M.D. is an Otolaryngologist at the University of Michigan and has given us an ENT surgeon's view of cranial nerves IX and X. Richard L. Doty, Ph.D., of the University of Pennsylvania, is one of the most prominent national and international figures in the field of olfaction and olfactory and other chemosensory disorders. With over 30 years of experience and nearly 200 publications, he has a command of the field that few can match; we are honored to have him join us for this issue of Seminars.