Cranial Nerve Disorders
Cranial nerves are those that occur directly from your brain or brainstem and often affect areas like the face and eyes. These disorders can result in several symptoms such as facial pain or twitching and include trigeminal neuralgia, hemifacial spasm and glossopharyngeal neuralgia.
There are twelve pairs of nerves that lead directly from the brain to various parts of the head, neck, and trunk. Some of the cranial nerves are involved in the special senses (seeing, hearing, and taste), and others control muscles in the face or regulate glands. The nerves are named and numbered (according to their location, from the front of the brain to the back).
The 12 Cranial Nerves:
- Abducens nerve: eye movement outward
- Facial nerve: muscles of facial expression, taste, salivary secretions
- Glossopharyngeal nerve: mouth & throat sensation, taste & salivary secretions
- Hypoglossal nerve: tongue movement
- Oculomotor nerve: most eye movements
- Olfactory nerve: sense of smell
- Optic nerve: sight
- Spinal accessory nerve: neck movement
- Trigeminal nerve: facial sensation and chewing muscles
- Trochlear nerve: eye movement down and inward
- Vagal nerve: swallowing, vocal cords, sensation & parasympathetic innervation of body organs
- Vestibulo-cochlear nerve: hearing and balance
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Cranial nerve disorders can occur for many different reasons. The most common cause of these problems is compression of cranial nerves due to a blood vessel pressing on the nerves. By separating the blood vessel from the affected nerve, these symptoms can improve or be eliminated in a majority of patients. The most commonly affected nerves by these vascular compression syndromes are: the trigeminal nerve, facial nerve, and glossopharyngeal nerve. When nerves responsible for sensation are affected, the term is referred to as neuralgia.
Different types of cranial disorders can cause different symptoms, based on which nerves are damaged, and where they’re located. Common symptoms include:
Bell’s Palsy – This condition occurs when the facial nerve is affected. It causes drooping of part of the face and usually only affects one side of the pface. This is often caused by a virus that causes swelling, which puts pressure on the facial nerve.
Microvascular Cranial Nerve Palsy – Microvascular cranial nerve palsy. This condition affects the nerves in the eye. It is most common in people who are diabetic and in those who have high blood pressure. Microvascular cranial nerve palsy can cause double vision and other problems with eyesight.
Bell’s palsy – This condition occurs when the facial nerve is affected. It causes drooping of part of the face and usually only affects one side of the pface. This is often caused by a virus that causes swelling, which puts pressure on the facial nerve.
Neurological exam along with other tests are required to diagnose cranial nerve disorders. Depending on the type of cranial neuropathy that is suspected, tests may include:
Magnetic Resonance Imaging (MRI) – MRI shows the soft tissues of the body and gives clearer picture of the brain, skull base and spine.
Computerized Tomography (CT Scan)- Combined CT scan and myleography produces image that clearly show both the bone structures of the spine and the nerve structures
Electromyography – A test that measures the electrical activity of muscles when working and at rest.
Angiography – A procedure in which a blood sample is checked to measure the amounts of certain hormones released into the blood by organs and tissues in the body.
Biopsy – Biopsy of the skin and nerves to find out severity of nerve damage.
Most cranial nerve disorders will get better with time, without any treatment. For some types of cranial nerve disorders, surgery is the best treatment options. There are also types nerve damage that cannot be treated or repaired. But it’s important to diagnose and treat any health conditions that are causing the nerve damage. Treating common causes like high blood pressure, infections, and diabetes can help to treat the neuropathy. Eating nutritious foods, avoiding smoking, and limiting alcohol are also helpful in managing cranial nerve disorders. At ONE® Brain & Spine Center®, we specialize in minimally invasive procedures to treat cranial nerve disorders.
Minimally Invasive Surgical Treatments
- Retromastoid Approach Minimally invasive retromastoid approach is made with an approximately one-inch skull opening via a two-inch skin incision behind the ear. This approach is used for acoustic tumor surgery because it results in high probability of the preservation of the facial nerve and hearing nerve functions.
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