Cranial nerve palsy is a form of palsy involving one or more of the cranial nerves. Palsy occurs when a muscle becomes paralyzed or someone loses control of it, experiencing erratic muscle movements, spastic jerks, and other problems. Those related to the cranial nerves are usually very easy to identify because they involve the muscles of the face, and people's faces change as a result of the palsy. A patient may find it difficult to smile, to control eye movements, and to engage in other facial expressions.
There are 12 pairs of cranial nerves running directly from the brain to various areas of the face through holes in the skull known as foramens. The cranial nerves allow for a very fine level of control over the facial muscles, allowing people to do everything from making minute eye movements to curling their lips. In people with cranial palsy, control over a muscle or group of muscles is lost, leading to drooping, paralysis, or erratic involuntary movements.
There are a number of reasons why someone might develop cranial nerve palsy. Facial or head trauma can be a cause, as this may directly damage a nerve. People can also experience this condition after a surgery in which a surgeon inadvertently damages one of the cranial nerves. Degenerative conditions like multiple sclerosis can also damage the nerves, as conditions such as diabetes and meningitis. High blood pressure has also been linked with cranial nerve palsy.
When someone recognizes changes in facial expression or movement, a neurologist should be consulted. The neurologist can conduct an examination to determine which cranial nerve or nerves are involved, and to determine the extent of the damage to the nerve. The neurologist can also start to explore potential causes of the cranial nerve palsy. It is important to provide a complete patient history, as information which may not seem relevant can be important for the diagnosis.
Cranial nerve palsy treatment relies on identifying the cause and addressing it. In some cases, it may not be possible to reverse the palsy, due to the damage to the nerve. In other instances, a patient may regain some muscle control. Patients sometimes also find that it helps to work with a physical therapist during the treatment process to work on muscle control and to develop coping skills. It is also important to regularly see a neurologist to determine whether or not there is new damage which may need to be addressed.