Define the following disorders associated with cranial nerves and the brachial plexus. in your response include, the name of the cranial and peripheral nerves involved, signs and symptoms associated with the disorder and current treatment. bell’s palsy (unilateral facial paralysis) sixth nerve palsy klumpke’s paralysis erb’s palsy saturday night palsy tic douloureux

Bell’s Palsy (unilateral facial paralysis)

Bell’s palsy is an idiopathic, peripheral facial nerve paralysis which is associated with parasympathetic stimulation to the lacrimal, salivary glands and anterior tongue area.

Sixth nerve palsy

Sixth nerve palsy is an eye movement disorder caused due to sixth cranial nerve damage. The sixth cranial nerve send signals to lateral rectus muscle located on the outer side of eye.

Klumpke’s paralysis

Klumpke’s paralysis is a birth injury of the brachial plexus nerve located in the shoulder region.  Klumpke’s paralysis is a brachial plexus injury that paralyses the lower arm and hand.

Erb’s Palsy

Erb’s Palsy is another brachial plexus injury that causes paralysis of the upper extremity and causes shoulder dystocia.

Saturday night palsy

A lipoma near the deep radial nerve may cause paralysis, wrist drop and loss of sensation in the fingers known as Saturday night palsy or sleep paralysis.

Tic Douloureux

Tic douloureux is also known as trigeminal neuralgia is a painful disorder of the fifth cranial nerve. The fifth cranial nerve or trigeminal nerve is responsible for detecting touch, pain, temperature and pressure sensations.

Explanation:

Bell’s Palsy (unilateral facial paralysis)

It is characterized as a facial muscle weakness, swelling and inflammation of facial nerves. Facial drop, drooling, jaw and ear pain, changes in taste buds and salivation, increased sensitivity to sound are some of the symptoms of Bell’s palsy. Bell’s palsy is generally caused due to viral infections and antiviral drugs are given to treat the condition. Corticosteroids are also added to the drug regimen to manage swelling, pain and inflammation. Physical therapy and decompression surgery is also indicated for patients who did not improve with medications alone.  

Sixth nerve palsy

The damage to this nerve weakens the lateral rectus muscle and eye crossing away from nose cannot take place. The most common symptom of sixth nerve palsy is double vision and impaired vision when looking in direction away from nose. This poor eye alignment is also known as crossed eye defect. Corticosteroids are given to patients of sixth nerve palsy so that bacterial inflammation can be treated. Prism glasses are given to patients of sixth nerve palsy to align their eyes and improve cross vision. Botulinum toxin injections are also given to these patients as it paralyzes muscles of one side of eye and corrects crossed vision.  

Klumpke’s paralysis

Symptoms of Klumpke’s paralysis are weakness and loss of movement in lower arm and hand. The affected arm is massaged gently and range of motion (ROM) exercises are performed. If the paralysis persists, infants are taken into nerve grafting surgery, tendon transfers etc.  

Erb’s Palsy

The cranial nerves C5 and C6 responsible for control and movement of upper extremity are injured. Therefore, child has difficulty in moving arm, bending elbow, and gripping objects. A diverse team of specialist including physical therapist, neurosurgeons, orthopedic surgeons, neurosurgeons and occupational therapist are needed to devise a treatment plan for Erb’s palsy patients. Surgical approach for Erb’s Palsy is recommended in the first six months of birth to get most effective results.

Saturday night palsy

Clinical symptoms of Saturday night palsy include motor weakness, sensory disturbance, and cervical disc problems. Treatment of Saturday night palsy can be done by supporting the radial nerve with splint and surgery for removal of lipoma can also be performed in suitable condition.

Tic Douloureux

The disease is characterized by sudden onset of excruciating pain in the jaw and forehead which might be triggered any type of facial movement such as talking, brushing the teeth, shaving, or changes in temperature. The treatment of choice for trigeminal neuralgia is carbamazepine which decrease the ability of trigeminal nerve to produce painful impulses. Other drugs in the medication regimen may include gabapentin, phenytoin, valproic acid, baclofen, oxycodone, and topiramate.

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