What Is Cranial Neuropathy?

Twelve pairs of cranial nerves are sent directly from the brain to different parts of the head and face. In addition to the third pair of cranial nerves that manage hearing and maintaining balance functions, the third to the ninth pairs of cranial nerves dominate the movement of the eyeballs, tongue, face and throat, and the fifth and third pairs of cranial nerves receive facial, tongue and throat Ministry feeling. The first cranial nerve is the olfactory nerve that senses the smell, and the second cranial nerve is the optic nerve, or optic nerve. Any pair of cranial nerve disorders can produce severe functional impairment, but trigeminal neuralgia, glossopharyngeal neuralgia, and Bell facial paralysis are the most common.

Cranial nerve disease

Overview of cranial nerve disease

Twelve pairs of cranial nerves are sent directly from the brain to different parts of the head and face. In addition to the third pair of cranial nerves that manage hearing and maintaining balance functions, the third to the ninth pairs of cranial nerves dominate the movement of the eyeballs, tongue, face and throat, and the fifth and third pairs of cranial nerves receive facial, tongue and throat Ministry feeling. The first cranial nerve is the olfactory nerve that senses the smell, and the second cranial nerve is the optic nerve, or optic nerve. Any pair of cranial nerve disorders can produce severe functional impairment, but trigeminal neuralgia, glossopharyngeal neuralgia, and Bell facial paralysis are the most common.

Cranial nerve disease disease type

Cranial nerve disease trigeminal neuralgia

Trigeminal neuralgia is related to the abnormal function of the trigeminal nerve (the fifth pair of cranial nerves) that conducts facial sensation to the brain.

It is manifested as recurrent severe tingling in the trigeminal nerve distribution area, which lasts for several seconds to several minutes. Adults of any age can develop primary trigeminal neuralgia, but the elderly are more common and the cause is unknown.

Symptoms

Trigeminal neuralgia can occur spontaneously, but it is usually induced by touching a specific part of the head and face (that is, the trigger point), or triggered by actions such as brushing teeth and chewing. It is a kind of severe lightning-like pain that suddenly recurs and suddenly ends . It can occur anywhere under the face. The most common are cheeks, nose, and jaw. Pain can recur more than 100 times a day or even countless.

. Diagnosis

Although there is no specific test method to distinguish between primary and secondary trigeminal neuralgia, this pain is characteristically easy to diagnose. In addition, other causes of facial pain need to be excluded, such as diseases of the jaw, teeth, sinuses, or secondary trigeminal neuralgia caused by tumor or aneurysm compression of the trigeminal nerve.

Treatment

Because this pain is transient and episodic, classic painkillers are usually ineffective. But other drugs, especially some antiepileptic drugs that stabilize nerve cell membranes, may be useful. Carbamazepine is preferred, and if carbamazepine is ineffective or has severe side effects, phenytoin may also be used. Baclofen and some antidepressants are also effective in some cases. Spontaneous remission is common but relapses after a long interval.

For example, trigeminal neuralgia is caused by ectopic blood vessels compressing the nerves adjacent to the brain tissue, which can be relieved by surgery, so that the pain can be relieved for at least a few years. For those patients who cannot relieve pain and are not suitable for surgery, alcohol injection can temporarily block nerve function. If the nerve block method is effective, the nerve can be severed by permanently cutting the nerve or injecting drugs. But this treatment can permanently leave a feeling of facial discomfort, so this is the last option.

Cranial nerve disease glossopharyngeal neuralgia

Glossopharyngeal neuralgia is a rare neurological disorder. It is a severe recurrent pain that is confined to the base of the tongue or the throat wall and can be radiated to the ipsilateral ear.

Glossopharyngeal neuralgia usually develops after the age of 40, with more men than women, and the cause is unknown.

Symptoms

The nature of pain is similar to trigeminal neuralgia. It is transient, episodic and severe pain, which can be induced by swallowing, chewing, talking, yawning and other actions. The pain can last from a few seconds to a few minutes and usually affects only one side.

Treatment

The drug is similar to trigeminal neuralgia, with carbamazepine, phenytoin, baclofen, and antidepressants effective. If the above drugs are not effective, nerve block or glossopharyngeal nerve root resection can be used.

Cranial nerve disease facial paralysis

Facial palsy (bell paralysis) is a sudden weakness or paralysis of one lateral muscle caused by abnormal facial nerve function.

Facial nerve is the cranial nerve that innervates the facial muscles. The cause of facial paralysis is unknown. It may be related to local nerve tissue swelling caused by viral infection of the facial nerve, compression of nerve tension or blood circulation disorders.

Symptoms

Sudden onset and pain behind the ears a few hours before the appearance of facial paralysis. Paralysis is limited to one side of the face, and the degree can range from a few hours to 1 to 2 days. The paralyzed side is flat and expressionless, with numbness and weight, and it feels like the face is distorted, but in fact it still feels normal. When the upper part of the face is affected, it is often difficult to close the affected side. Rarely, facial paralysis can affect salivary glands, lacrimal gland secretion, and taste.

. Diagnosis

Facial paralysis always affects one face (upper and lower), and paralysis occurs suddenly. Facial palsy caused by stroke is often limited to the lower part of the face, and is accompanied by weakness in the upper and lower limbs.

Other diseases that cause facial paralysis are rare and often start slowly. They include: brain tumor compression, viral infections (such as herpes simplex virus, Ramsay Hunt syndrome), middle ear mastoid infection, Lyme disease, cranial Bottom deformity and so on. These diseases can be ruled out by medical history, blood tests, X-ray, CT, and MRI. There is currently no special examination for facial paralysis.

Treatment

There is no special treatment for facial paralysis. Corticosteroids such as prednisone may be effective for 1 to 2 weeks after 2 days of symptoms. But there is no reliable conclusion as to whether this can reduce pain and promote recovery.

If the eyelids cannot be closed, lubricate eye drops or goggles can be used every few hours to protect the eyes. Massage the paralyzed facial muscles to help recovery. If facial paralysis lasts for 6 to 12 months or more, surgery can be considered to transplant healthy nerves (usually hypoglossal nerves) into paralyzed facial muscles.

Prognosis

Local facial paralysis usually recovers completely within 1 to 2 months, while patients with complete facial paralysis have a different prognosis, but most recover. To determine the chance of recovery, doctors can perform a facial nerve stimulation test. Occasionally, involuntary facial muscle movements or tears may occur due to abnormal axonal connections formed by the facial nerve.