Radiation Oncology/Anatomy/Clinical syndromes with cn palsy

Cerebellopontine Angle Syndrome

• Acoustic Tumours
• CN IX and CN VIII and CN V can be affected
• Symptoms:
  • IX:
    • Tinnitus
    • Gag reflex decreased
  • VIII:
    • Vertigo
    • Deafness
  • V
    • Facial Sensory defecit

Jugular Foramen Syndrome (Vernet Syndrome)

• Glomus Jugular Tumours
• Base of skull fx
• Meningioma

• CN IX, X, XI
• Symptoms:
  • Dull unilat aching pain behind ear
  • XI
    • Ipsilateral Trapezius and SCM palsy
  • IX
    • Depressed gag reflex
    • Loss of taste at post 1/3 tongue
    • Loss pf sensation of uvula
  • X
    • Dysphonia
    • Dysphagia
    • Palatal drop
    • Loss of sensation of pharynx and larynx

Retropharyngeal & Retroparotid Space Syndrome

Collet-Sicard Syndrome

• CN IX, X, XI, XII
• Symptoms:
  • Paralysis of the vocal cords, palate, trapezius muscle and sternocleidomastoid muscle.
  • Anaesthesia of the larynx, pharynx and soft palate.

Villaret's Syndrome (Retroparotid)

• CN IX, X, XI, XII, Sympathetic chain and sometime CN VII
• Symptoms:
  • IX
    • Loss of posterior taste of tongue
    • Depressed gag reflex
  • X
    • Loss of sensation of soft palate, pharynx and larynx
  • XII
    • Ipsilateral deviation of tongue
  • Sympathetic involvement
    • Horner's syndrome