What would be the effect of damage to cranial nerve?

Cranial nerve damage occurs when any of the twelve cranial nerves are damaged as a result of injury to the nervous system. Common causes of cranial nerve injury include damage to the brain e.g. stroke or a traumatic brain injury.

Speech and language therapy is highly beneficial for individuals with cranial nerve damage. Speech and language therapy will provide the individual and others involved in their care with exercises, strategies and advice in helping them to reach their full potential in their communication, eating and drinking.

What is cranial nerve damage?

Cranial nerve damage is an injury to any of the twelve cranial nerves within the nervous system. Cranial nerve damage is commonly caused by a stroke or traumatic brain injury. There are twelve pairs of cranial nerves in the central nervous system; each cranial nerve serves a different function. Depending on which nerves have been damaged there will be different symptoms and difficulties.

Cranial nerves

The nervous system comprises of twelve pairs of cranial nerves, each with their own function. The cranial nerves and their functions include:

  • Olfactory nerve This nerve is responsible for the sense of smell.
  • Optic nerve This nerve is responsible for sending visual information to the brain.
  • Oculomotor nerve This nerve is responsible for most of the movement of the eye.
  • Trochlear nerve This nerve is also responsible for specific movements of the eye.
  • Trigeminal nerve This nerve is responsible for receiving sensation from the face and controls the muscles responsible for chewing.
  • Abducens nerve Is responsible for the abduction of the eye.
  • Facial nerve The facial nerve is responsible for the movement of the facial muscles, taste in the anterior 2/3 of the tongue and some of the tongue movements.
  • Vestibulocochlear nerve This nerve is responsible for the sense of sound, gravity and movement (important for balance). It is also plays an important role in hearing.
  • Glossopharyngeal nerve This nerve is responsible for taste in the posterior 1/3 of the tongue and some of the movements of the tongue.
  • Vagus nerve This nerve is responsible for the muscles involved in swallowing, voice and resonance.
  • Accessory nerv This nerve controls specific muscles involved in the movement of the neck and shoulders.
  • Hypoglossal nerve This nerve controls the movement of the tongue which is important for speech and swallowing.

The type of difficulty experienced by individuals with cranial nerve damage will vary depending on what cranial nerves have been affected. Damage to a specific cranial nerve will cause a difficulty in its particular function. Common difficulties experienced by individuals with cranial nerve damage include:

  • Impairment in any of the senses including hearing, sight, smell, taste and touch.
  • Difficulty in speaking.
  • Swallowing difficulties.
  • Difficulty with walking, standing and sitting.
  • Muscle weakness or incoordination.
  • Muscle pain.
  • Difficulty with sleep.
  • Muscle spasms.
  • Numbness of the skin.
  • Loss of sensation.
  • Deafness.
  • Double vision.

How is cranial nerve damage diagnosed?

Cranial nerve damage will be diagnosed by a team of medical professionals. A diagnosis will include a full neurological examination including asking the patient to carry out specific tasks and also scans of the brain.

The speech and language therapist will play a key role in helping to identify cranial nerve damage for patients who are experiencing any difficulties with their speech, voice or swallowing. The speech and language therapist will carry out several examinations for individuals with cranial nerve damage to help determine the severity of the damage to their speech or swallowing.

What difficulties caused by cranial nerve damage can SLT UK help with?

The effects of cranial nerve damage will vary for each individual; the type of difficulties experienced will depend on the cranial nerve which has been affected and also the severity of the damage. The effects of cranial nerve damage can range from mild to severe and will affect individuals in different ways.

Our speech and language therapists can help individuals who have cranial nerve damage with attention and listening problems, communication problems, swallowing difficulties, voice and speech problems.

How does speech and language therapy help individuals with cranial nerve damage?

Speech and language therapy can be extremely beneficial for individuals with cranial nerve damage. Speech and language therapy is particularly beneficial for individuals who have swallowing and speech difficulties as a result of cranial nerve damage. Speech and language therapy will focus on helping to regain lost ability, or create compensatory strategies to help minimise the effects the difficulty is having on the individual. Speech and language therapy can also help others involved in the individual's care by providing support and advice for the management of their difficulty.

Speech and language therapy may benefit those with cranial nerve damage as any aspect of their communication or swallowing difficulties may improve. It may also reduce stress and anxiety of patients with cranial nerve damage as they are receiving supportive input from a speech and language therapists.

What would speech and language therapy treatment for cranial nerve damage involve?

Speech and language therapy would initially involve an assessment which includes a number of observations, examination and assessments to help determine the type of speech, language and swallowing difficulties the individual is experiencing. An initial assessment will also determine the severity of these difficulties and what the best treatment option would be.

Following an initial assessment, treatment for speech and language therapy may include assessments, reports, therapy programmes, reviews, support groups, training and advice.

Treatment will vary depending on the individual. Speech and language therapy will provide an individualised treatment plan specifically tailored to the patient’s needs and abilities.

Specific treatment for cranial nerve damage may include:

  • Voice therapy
  • Articulation therapy
  • Oral-motor exercises
  • Breathing exercises
  • Augmentative and Alternative Communication
  • Eating, drinking and swallowing management
  • Compensatory strategies

Summary

Cranial nerve damage occurs when any of the twelve cranial nerves are damaged as a result of injury to the nervous system. The type and severity of the difficulties experienced will vary for each individual and be dependent on the specific nerves that have been damaged. Speech and language therapy is highly beneficial in treating individuals with cranial nerve damage.

If you feel you may benefit from speech and language therapy or would like any more information on our services please email or call 0330 088 5643.

CN injuries that occur during CEA are due to prolonged retraction and transection, as well as inadvertent stretching and clamping of the CNs that are in the vicinity of the surgical field.

From: Handbook of Clinical Neurology, 2017

1. Snell RS. Clinical Neuroanatomy. Philadelphia, PA: Lippincott Williams & Wilkins; 2001. [Google Scholar]

2. Remley KBHH, Smoker WRK, Osborn AG. CT and MRI in the evaluation of glossopharyngeal, vagal, and spinal accessory neuropathy. Semin Ultrasound CT MR. 1987;(8):284–300. [Google Scholar]

3. Afifi AKBR. Functional Neuroanatomy. 2. New York City, NY: McGraw-Hill Professional; 2005. [Google Scholar]

4. Goetz CG. Textbook of Clinical Neurology. 3. Philadelphia, PA: Saunders; 2007. [Google Scholar]

5. Castillo M, Mukherji SK. Magnetic resonance imaging of cranial nerves IX, X, XI, and XII. Topics in magnetic resonance imaging. 1996;8(3):180–186. [PubMed] [Google Scholar]

6. Parent A. Carpenter’s Human Neuroanatomy. 9. Baltimore, MD: Williams & Wilkins; 1996. pp. 442–451. [Google Scholar]

7. Bastian RW, Riggs LC. Role of sensation in swallowing function. The Laryngoscope. 1999;109(12):1974–1977. [PubMed] [Google Scholar]

8. Sulica L, Hembree A, Blitzer A. Swallowing and sensation: evaluation of deglutition in the anesthetized larynx. The Annals of otology, rhinology, and laryngology. 2002;111(4):291–294. [PubMed] [Google Scholar]

9. Sasaki CT. Electrophysiology of the Larynx. In: Blitzer A, Brin MF, Sasaki CT, Fahn S, Harris KS, editors. Neurologic disorders of the larynx. New York: Thieme Medical Publishers; 1992. pp. 45–53. [Google Scholar]

10. Aronson AE. Clinical voice disorders : an interdisciplinary approach. 2. New York: Thieme; 1985. p. xii.p. 417. [Google Scholar]

11. Jiang J, Lin E, Hanson DG. Vocal fold physiology. Otolaryngologic clinics of North America. 2000;33(4):699–718. [PubMed] [Google Scholar]

12. Sataloff RT, Mandel S, Gupta R, Mandel H. Neurologic Disorders Affecting the Voice in Performance. In: Sataloff RT, editor. Clinical assessment of voice. San Diego: Plural Publishing; 2005. pp. 201–223. [Google Scholar]

13. Sataloff RT, Hawkshaw M, Anticaglia J. Patient History. In: Sataloff RT, editor. Clinical assessment of voice. San Diego: Plural Publishing; 2005. pp. 1–16. [Google Scholar]

14. Woodson GE, Blitzer A. Neurologic Evaluation of the Larynx and the Pharynx. In: Cummings CW, Flint PW, Harker LA, et al., editors. Cummings otolaryngology head & neck surgery. 4. Philadelphia: Elsevier Mosby; 2005. pp. 2054–2064. [Google Scholar]

15. Martino R, Foley N, Bhogal S, et al. Dysphagia after stroke: incidence, diagnosis, and pulmonary complications. Stroke; a journal of cerebral circulation. 2005;36(12):2756–2763. [PubMed] [Google Scholar]

16. Tatemichi TK, Freddo L, Mohr JP, Blitzer A. Pyramidal Disease. In: Blitzer A, Brin MF, Sasaki CT, Fahn S, Harris KS, editors. Neurologic disorders of the larynx. New York: Thieme Medical Publishers; 1992. pp. 229–239. [Google Scholar]

17. Hartelius L, Svensson P. Speech and swallowing symptoms associated with Parkinson’s disease and multiple sclerosis: a survey. Folia Phoniatr Logop. 1994;46(1):9–17. [PubMed] [Google Scholar]

18. Brin MF, Fahn S, Blitzer A, Ramig LO, Stewart C. Movement Disorders of the Larynx. In: Blitzer A, Brin MF, Sasaki CT, Fahn S, Harris KS, editors. Neurologic disorders of the larynx. New York: Thieme Medical Publishers; 1992. pp. 248–278. [Google Scholar]

19. Blumin JH, Pcolinsky DE, Atkins JP. Laryngeal findings in advanced Parkinson’s disease. The Annals of otology, rhinology, and laryngology. 2004;113(4):253–258. [PubMed] [Google Scholar]

20. Hanson DG, Gerratt BR, Ward PH. Cinegraphic observations of laryngeal function in Parkinson’s disease. The Laryngoscope. 1984;94(3):348–353. [PubMed] [Google Scholar]

21. Adler CH, Bansberg SF, Hentz JG, et al. Botulinum toxin type A for treating voice tremor. Archives of neurology. 2004;61(9):1416–1420. [PubMed] [Google Scholar]

22. Sataloff RT, Deems DA. Spasmodic Dysphonia. In: Sataloff RT, editor. Clinical assessment of voice. San Diego: Plural Publishing; 2005. pp. 241–256. [Google Scholar]

23. Watts CR, Truong DD, Nye C. Evidence for the effectiveness of botulinum toxin for spasmodic dysphonia from high-quality research designs. J Neural Transm. 2008;115(4):625–630. [PubMed] [Google Scholar]

24. Rubin AD, Wodchis WP, Spak C, Kileny PR, Hogikyan ND. Longitudinal effects of Botox injections on voice-related quality of life (V-RQOL) for patients with adductory spasmodic dysphonia: part II. Archives of otolaryngology--head & neck surgery. 2004;130(4):415–420. [PubMed] [Google Scholar]

25. Siddique N, Siddique T, Sufit R. Degenerative Motor, Sensory, and Autonomic Disorders. In: Goetz CG, editor. Textbook of Clinical Neurology. Philadelphia: Saunders Elsevier; 2007. [Google Scholar]

26. Haverkamp LJ, Appel V, Appel SH. Natural history of amyotrophic lateral sclerosis in a database population. Validation of a scoring system and a model for survival prediction. Brain. 1995;118 ( Pt 3):707–719. [PubMed] [Google Scholar]

27. Brackmann DE, Arriaga M. Extra-Axial Neoplasms of the Posterior Fossa. In: Cummings CW, Flint PW, Harker LA, et al., editors. Cummings otolaryngology head & neck surgery. 4. Philadelphia: Elsevier Mosby; 2005. pp. 3803–3844. [Google Scholar]

28. Gorlin RJ, Cohen MM, Hennekam RCM. Syndromes of the head and neck. 4. Oxford [England] ; New York: Oxford University Press; 2001. p. xiv.p. 1283. [Google Scholar]

29. De Simone R, Ranieri A, Bilo L, Fiorillo C, Bonavita V. Cranial neuralgias: from physiopathology to pharmacological treatment. Neurol Sci. 2008;29 (Suppl 1):S69–78. [PubMed] [Google Scholar]

30. Myssiorek D. Recurrent laryngeal nerve paralysis: anatomy and etiology. Otolaryngologic clinics of North America. 2004;37(1):25–44. v. [PubMed] [Google Scholar]

31. Richardson BE, Bastian RW. Clinical evaluation of vocal fold paralysis. Otolaryngologic clinics of North America. 2004;37(1):45–58. [PubMed] [Google Scholar]

32. Woodson GE. Configuration of the glottis in laryngeal paralysis I & II. The Laryngoscope. 1993;103(11 Pt 1):1227–1241. [PubMed] [Google Scholar]

33. Rosenthal LH, Benninger MS, Deeb RH. Vocal fold immobility: a longitudinal analysis of etiology over 20 years. The Laryngoscope. 2007;117(10):1864–1870. [PubMed] [Google Scholar]

34. Mulpuru SK, Vasavada BC, Punukollu GK, Patel AG. Cardiovocal syndrome: a systematic review. Heart, lung & circulation. 2008;17(1):1–4. [PubMed] [Google Scholar]

35. Fang TJ, Li HY, Gliklich RE, et al. Quality of life measures and predictors for adults with unilateral vocal cord paralysis. The Laryngoscope. 2008;118(10):1837–1841. [PubMed] [Google Scholar]

36. Hogikyan ND, Sethuraman G. Validation of an instrument to measure voice-related quality of life (V-RQOL) J Voice. 1999;13(4):557–569. [PubMed] [Google Scholar]

37. Mao VH, Abaza M, Spiegel JR, et al. Laryngeal myasthenia gravis: report of 40 cases. J Voice. 2001;15(1):122–130. [PubMed] [Google Scholar]

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Cranial Nerves Involved in Swallowing

Cranial NerveSwallowing Function
V-TrigeminalMuscles of mastication, sensation to the face including oral mucosa and anterior 1=3 of tongue
VII-FacialTaste to anterior 1=3 of tongue, motor function to lips (oral competence)
IX-GlossopharyngealSensation and taste to posterior 1=3 of tongue
X-VagusSensation to larynx, motor function to soft palate, pharynx, larynx, and esophagus
XII-HypoglossalMotor innervation to intrinsic and extrinsic tongue musculature

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