Cranial nerve damage

Introduction Cranial nerve damage: causes various causes of other peripheral nerve diseases, can cause cranial nerve damage. The damage of the cranial nerve can be single, called single cranial nerve disease, but because the distribution of cranial nerves is concentrated, especially in some common channels, local factors can often damage two or more adjacent cranial nerves. Most single neuropathy, but its cause can be similar to single neuropathy, the lesion can be in the brain or extracranial, the intracranial can be in the brain (bundle) or outside the brain. III to VII on the cranial nerve nucleus in the brain stem, so there may be cranial nerve symptoms in the brain stem damage, which is characterized by cross-cutting phlegm, many cranial neuropathy secondary to tumor, meningitis, vascular disease, demyelinating disease Spontaneous stenosis, sometimes local or early manifestations of systemic diseases, should be identified.

Cause

Tongue, vagus, accessory and sublingual nerve damage Cranial nerve damage Tongue, vagus, accessory and hypoglossal nerves originate from the medulla oblongata, and the path behind the medulla is closely adjacent, which is called the posterior cranial nerve, often involved at the same time. Among them, the pharyngeal and vagus nerves have a common initial nucleus and a close surrounding path, so the clinically combined damage is particularly caused, resulting in medullary paralysis. However, primary glossopharyngeal neuralgia is affected alone. There are many causes of pharyngeal, vagus, sublingual and accessory nerve damage, such as skull base depression, ring pillow fusion malformation, cerebellopontine angle tumor, polyneuritis, cranial neuritis, meningitis, trauma and so on. Because the etiology has different pathogenesis, such as inflammatory infiltration, demyelination and so on.

an examination

Related inspection

Cranial CT examination of intracranial pressure monitoring of brain MRI examination F-wave accessory nerve examination

1. Tongue, vagus nerve fistula: can cause medullary paralysis, manifested as dysarthria and difficulty swallowing. The dysarthria can be hoarse, with nasal, unclear, or even completely aphasia. Dysphagia can be a swallowing disorder, when you have a cough, and you can't swallow at all. Check that one or both sides of the soft palate can not be lifted, and one side can see the vertical movement of the uvula. Pharyngeal sensation and pharyngeal reflexes are slow or lost.

2. Paraneospasm: due to sternocleidomastoid tendon, low muscle tone, muscle atrophy, difficulty in turning. One side of the paralysis is that the head cannot turn to the healthy side, the trapezius tendon, the muscle tension is low, the muscles are atrophied, and the shoulders cannot be shrugged.

3. Sublingual nerve spasm: the tongue is extended to the affected side, the tongue muscle is atrophied, and the lingual muscle fiber is tremor.

Differential diagnosis

[Differential diagnosis]

(A) acute inflammatory demyelinating polyneopathy (acute inflammutory demyelinating polynearopathy): the first symptom, often symmetrical symmetry of the limbs with feeling glove-like obstacles. There may be multiple cranial nerves damaged at the same time, or a single cranial nerve may be damaged. Often involved are pharynx, vagus, deputy and facial nerves, such as head tilt, hoarseness, cough, facial paralysis. Cerebrospinal fluid is a protein-cell separation phenomenon.

(B) congenital anomalies of atlanto-occpital region: more short neck or torticollis, posterior hairline, facial asymmetry and so on. The onset is slow, and the symptoms of the nervous system examination are mainly the symptoms of the cranial nerve, cerebellum, upper cervical spinal cord and cervical nerve compression in the posterior group. The most common headaches, dizziness, neck and neck pain, often caused by head activity or physical labor, ataxia, walking instability, nystagmus is relatively common, individual cases have unclear articulation, hoarseness, difficulty swallowing, Difficulty breathing, hernia, tongue muscle atrophy, sternocleidomastoid weakness, facial paralysis, deafness, etc. Skull flat measurement of skull base can be abnormally changed.

(C) cerebellopontine angle tumours: patients with slow onset, the clinical symptoms of bridge cerebral angle syndrome and increased intracranial pressure, when the tumor develops downward, oppress the IX, X, XI cranial nerve, Can cause difficulty swallowing, eating cough, hoarseness, ipsilateral pharyngeal reflex or disappearance, soft paralysis, sternocleidomastoid muscle and trapezius muscle weakness. Sublingual nerve involvement is rare. Head CT, MRI can be found in the tumor growth site

(4) intracranial metastatic tumors: nasopharyngeal carcinoma or sarcoma from the skull base can invade the posterior cranial nerve and cause paralysis. The course of the disease is short, there may be bloody nasal secretions, and there are many metastases in the cervical lymph nodes. Otolaryngology and biopsy can be confirmed.

(5) Arachnoid membrane adhesim: There is a history of fever before the disease, there may be a chronic history of meningitis, a long course of disease, symptoms of cranial nerve palsy, such as difficulty swallowing, hoarseness, unclear articulation, Facial nerve palsy, etc., cerebrospinal fluid examination increased white blood cell count.

(6) Central (false) bulging paralysis: also known as upper motor neuron or nuclear medullary paralysis, caused by bilateral cortical medullary bundle damage. Can be seen in cerebral arteriosclerosis, multiple cerebral infarction, encephalitis and so on. The clinical manifestations are mainly speech speech unclear, and the difficulty in swallowing is caused by the fact that the tongue cannot transport food to the pharynx. The pharyngeal reflex still exists, and the brainstem reflex such as mandibular reflex and palmar reflex can be hyperthyroidism; it can be accompanied by pyramidal tract sign and strong crying and strong laughter.

(7) Syringomyelia: lesions involving the medulla oblongata, suspicion of nuclear invasion, ipsilateral soft palate and vocal cord paralysis, drinking water cough, difficulty swallowing and dysarthria. The trigeminal nucleus is involved in the nucleus, and the ipsilateral side is bought for your lack of nuclear pain. Sublingual nerve spasm: the tongue is extended to the affected side, the tongue muscle is atrophied, and the lingual muscle fibers are tremor. An MRI examination clearly shows the location and size of the cavity in the sagittal and transverse sections.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.