Cranial nerve palsy

Introduction Cranial nerve palsy, usually facial nerve injury, can also have three nerves, glossopharyngeal nerve, vagus nerve injury. The principle of cerebral nerve palsy caused by aneurysm may be due to acute expansion of saccular aneurysm, direct compression or traction of the nerve; or aneurysmal hemorrhage, causing nerves to move; or edema due to venous congestion; or arachnoid adhesion due to bleeding Wait. If the aneurysm does not continue to expand, and thrombosis occurs, the symptoms of the eye tendon can be alleviated. Oculomotor palsy caused by aneurysms is almost accompanied by dilated and fixed pupils (90% to 96.8%), and pain or headache (92%) in the affected side. The drooping of the affected eyelid is also more common (about 60%).

Cause

About a quarter of cranial nerve palsy is unknown, and half of it will automatically recover. Diabetes, hypertension, and hardening of the arteries are often the main causes of cranial nerve palsy, and they need to be examined and treated for the above diseases. Trauma also often causes the fourth and sixth pairs of cranial nerve palsy. Others such as elevated brain pressure, tumors, inflammation, and viral infections may cause cranial nerve palsy, which needs further examination to determine. The strabismus caused by cranial nerve palsy can cover the problem of double vision at a glance, and has not recovered after half a year of observation, and then consider surgery.

an examination

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Intracranial and intraorbital hematoma can be diagnosed by CT scan. The internal carotid cavernous fistula can be diagnosed by CT enhanced scan or cerebral angiography.

Intraocular tendons can sometimes be caused by eyeball injuries and ciliary ganglion injuries. The prognosis of cranial nerve palsy after injury depends on the nature and extent of the injury, and the general prognosis is good. Intracranial and intraorbital hematoma can be diagnosed by CT scan. The internal carotid cavernous fistula can be diagnosed by CT enhanced scan or cerebral angiography.

Cerebral palsy complicated by diabetes is most common with oculomotor nerves and abductor nerve paralysis. Among the acquired oculomotor palsy, diabetics account for 6% to 25%. Among the acquired abductor neural crests, diabetics accounted for approximately 15.4%. When the oculomotor nerve is involved, the pupil often remains normal. Because the sacral fiber is located in the peripheral part of the oculomotor nerve, it is not susceptible to diabetic ischemic lesions. This is different from the oculomotor numbness caused by aneurysm. of. Eye muscle spasm can be improved or restored with the control of diabetes.

Differential diagnosis

In the third pair of cranial nerve palsy, there will be drooping of the eyelids, and the eyeballs cannot turn up, down, and inward to form exotropia, which causes diplopia due to strabismus. When the pupil becomes larger, the amplitude of the ciliary muscle becomes worse, and it is impossible to see the object at a close distance. The treatment of the sputum is observed for six months to one year, and if surgery cannot be resumed, the surgical treatment is considered.

The fourth pair of cranial nerve palsy will cause the side to look at things, or the chin will retract and turn the head to the side to see the object. This is because the fourth pair of trochlear nerves will form up and down strabismus, leading to double vision. In order to avoid double vision, the above head position changes. Sometimes children have congenital trochlear nerve paralysis, but they are mistaken because of head lice. It is thought to be a neck surgery due to torticollis. The trochlear nerve is easy to be injured because it is long and thin. If it does not recover after six months to one year after paralysis, surgery should be considered.

Cranial nerve palsy, usually facial nerve injury, but also sacral nerve, glossopharyngeal nerve, vagus nerve injury. The aneurysm caused by cerebral nerve palsy may be caused by acute expansion of the saccular aneurysm, directly compressing or pulling the nerve; or bleeding of the aneurysm, causing nerve displacement; or edema caused by venous congestion; or arachnoid caused by bleeding Adhesive and so on. If the aneurysm does not continue to expand, and thrombosis occurs, the symptoms of the eye tendon can be alleviated. Oculomotor palsy caused by aneurysms is almost accompanied by dilated and fixed pupils (90% to 96.8%), and pain or headache (92%) in the affected side. The drooping of the affected eyelid is also more common (about 60%).

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