CORRECTNESS AND PUNCTUALITY IS NEEDED PLEASE

The facts underlying this dispute are relatively simple. Respondent Palmer is an inmate at the Bland Correctional Center in Bland, Va., serving sentences for forgery, uttering, grand larceny, and bank robbery convictions. On September 16, 1981, petitioner Hudson, an officer at the Correctional Center, with a fellow officer, conducted a "shakedown" search of respondent's prison locker and cell for contraband. During the "shakedown," the officers discovered a ripped pillowcase in a trash can near respondent's cell bunk. Charges

520

*520against Palmer were instituted under the prison disciplinary procedures for destroying state property. After a hearing, Palmer was found guilty on the charge and was ordered to reimburse the State for the cost of the material destroyed; in addition, a reprimand was entered on his prison record.

Question 11

How would you treat optic neuritis?

20Question 12

After two episodes of optic neuritis, one affecting each eye and 2 months

apart, confirmed to be demyelinating in nature by visual evoked

potentials, could a diagnosis of multiple sclerosis be reached in the

absence of periventricular lesions on the MRI?

Question 13

While assessing the pupillary reflexes, the consensual light reflex is really

difficult to see in the other eye. Are there any tips for that?

Question 14

Is it clinically significant to examine the consensual light reflex? If there

is a lesion of the IIIrd cranial nerve of the unilluminated eye to impair the

consensual response, this will be clear by the other symptoms and signs

of the IIIrd cranial nerve palsy on that eye. If there is a lesion of the optic

nerve of the unilluminated eye, the patient will not have a direct light

reflex of that eye when examining its own direct reflex. I am not sure

how the IIIrd cranial nerve can lose only its parasympathetic fibres. It is

difficult to see the unilluminated pupil when light is not directly shining

on it.

Question 15

Should every patient with trigeminal neuralgia be given an MRI of the

brain?

Question 16

Is carbamazepine more effective than phenytoin in the treatment of

trigeminal neuralgia? Would this patient need a higher dose of

carbamazepine, and what is the upper limit?

Question 17

Is gabapentin effective in the treatment of trigeminal neuralgia?

Question 18

What medication is best used for the treatment of carbamazepineresistant trigeminal neuralgia?

Question 19

What are the common causes of recurrent lower motor facial nerve

palsy?

Question 20

In a case of facial nerve palsy, what is the value of preserved taste

sensation? Does its preservation exclude upper motor affection and/or

nuclear lesion or is it localized between the facial canal and the

cerebellopontine angle?