Cranial Nerve Examination
A complete cranial nerve examination walks CN I to CN XII in sequence. This checklist keeps the order fixed so you never lose marks skipping olfaction or forgetting to test accommodation, and flags the lesions each abnormal finding points to.
Introduction
0/5CN 1: Olfactory
0/1CN 2: Optic
0/9~1:20 people have asymmetrical pupils normally
Not in front, to avoid testing accommodation
Place object ~20cm from eyes, ask patient to look at wall then object
Screening test for hemianopia / quadrantanopia
CN 3, 4, 6: Oculomotor, trochlear, abducens
0/3CN 5: Trigeminal
0/6CN 7: Facial
0/7CN 8: Acoustic
0/5Positive test: nystagmus after latent period, waxing then waning. No latent period or persistent nystagmus suggests central lesion
Normally, air conduction > bone conduction. Rinné negative in conduction deafness
Sound localizes to normal ear in nerve deafness, to affected ear in conduction deafness
CN 9 and 10: Glossopharyngeal & Vagus
0/3Should lift symmetrically. Unilateral weakness deviates away from lesion
Important for swallow and risk of aspiration
CN 11: Accessory
0/2Test SCM strength by resisting head turn
CN 12: Hypoglossal
0/2Tongue will deviate towards the lesion
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