Bilateral Cranial IX and X Nerve Palsies After Mild Traumatic Brain Injury

Ann Rehabil Med. 2016 Feb;40(1):168-71. doi: 10.5535/arm.2016.40.1.168. Epub 2016 Feb 26.

Abstract

We report a 57-year-old man with bilateral cranial nerve IX and X palsies who presented with severe dysphagia. After a mild head injury, the patient complained of difficult swallowing. Physical examination revealed normal tongue motion and no uvular deviation. Cervical X-ray findings were negative, but a brain computed tomography revealed a skull fracture involving bilateral jugular foramen. Laryngoscopy indicated bilateral vocal cord palsy. In a videofluoroscopic swallowing study, food residue remained in the vallecula and pyriform sinus, and there was reduced motion of the pharynx and larynx. Electromyography confirmed bilateral superior and recurrent laryngeal neuropathy.

Keywords: Basilar skull fracture; Cranial nerve diseases.