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ninth cranial nerve palsy
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ninth cranial nerve palsy

History: 30 y/o female. post total thyroidectomy (1 year).  Left lobe 5 cm benign complex cyst, right lobe benign 1 cm solid mass.  Never had thyroid issues before.  6 weeks post surgery complained of 'lump' in throat.  No anatomical abnormality noted.  2 months  later complained of 'lump' in throat (left side) and hard to swallow.  Told that the nerves were still healing from surgery.  I am just now beginning to get my thyroid levels straight (TSH from .001 to 38).  I am at TSH of 1.7.  I have still had extreme fatigue, headaches, menstral issues (even on BC), extreme depression/anxiety (never had issues until after surgery) overall muscle/joint aches.

Symptoms:  3 weeks ago, the 'lump' feeling was at it's worse and it was accompanied by a sore, horse voice and left ear pain.  I assumed it was a cold and never saw my gp.  The pain in the left backside of my tongue increased daily until 5 days ago when my left side of tongue/throat went completely numb.  I cannot feel hot/cold fluids and have trouble swallowing food bc there is no sensation to need to swallow.  5 days ago the ear pain was made worse by drinking and noise.  The left side of my face from my ear to midlip was numb and my face felt tight. I also had chest pain on the left side.  It feel more like muscle cramps/spams from sternum to left shoulder.  It did not feel heart related (even though I have been experiencing irregular heartbeats especially when laying down.) I went to my gp and he tested my 'gag' reflex and it was okay on the right side but gone on the left.  He said it was ninth cranial nerve palsy and said he had heard of it but never seen it.  He sent me the following day for an MRI of the brain and neck.  Results came back normal.  Saw neuro today and he said MRI was normal and that he didn't know what was going on.  He said that the face issue was 7th nerve, swallowing issues were 12th and tongue was 9th.  He suggested I talk to my surgeon to see if nerve damage was possible or go see an ENT to see if it is a motor defect.

Could it be just several kinds of palsy?  Could it be HE?  I was never tested for autoimmune thyroid, just my TSH was tested.  I was 20 weeks pregnant at the time.  The larger cyst was pressing on my windpipe and they (surgeon and OB) said it needed to come out asap.  I was 24 weeks along when I had surgery.  Should I refer to an ENT?

Any thoughts you have are greatly appreciated.

Julie
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Okay, so I'm sorry to ask a question before anyone has responded, but I am at medical training.  Two of my associates are nurses.  As we were eating, which I'm staying with soft foods right now, I got really strangled.  They kept asking me if I was alright and I couldn't speak bc of choking.  After I was able to catch my breath, I told them about what was going on.  Both of them mentioned something about being worried about aspiration and getting lung problems bc of food going into the lung.  Is this true?  I'm just out of town with work until next tuesday night and I'm a bit worried now.

Help, anyone I'm desperate for some sort of answer.
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Avatar_n_tn
Hi,
9th cranial nerve palsy is diseases of the 9th cranial (glossopharyngeal) nerve or its nuclei in the medulla. The nerve may be injured by diseases affecting the lower brain stem, floor of the posterior fossa, jugular foramen, or the nerve's extra cranial course. Clinical manifestations include loss of sensation from the pharynx, decreased salivation, and syncope. Glossopharyngeal neuralgia refers to a condition that features recurrent unilateral sharp pain in the tongue, angle of the jaw, external auditory meatus and throat that may be associated with SYNCOPE. Episodes may be triggered by cough, sneeze, swallowing, or pressure on the tragus of the ear. (Adams et al., Principles of Neurology, 6th Ed, p1390).
It is true that if you have symptoms like this, then there are probably chances of aspirating.
Bye.
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Avatar_n_tn
Damn.. im experiencing some of these things.. i hav a lump in the left side of throat.. its hard to swallow with the left side..my uvula turns to the left.. so thts a definite symptom of ninth cranial nerve dysfunction.. im going to see a nurologist.. but i know how this happened.. it happened right after a big pop in my neck while yawning.. ever since then ive felt the lump n all other symptoms.. ive also experienced hearing changes.. did u recover from this??
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