Cranial nerve palsies in cervical injuries

The occurrence of cranial nerve palsies in cervical injuries is described in eight patients. The clinical features were dramatic and usually presented soon after injury, the most common picture being that of a bulbar palsy, with acute respiratory distress and dysphagia. Neurologic recovery, both from cranial nerve palsies and motor and sensory deficits, was substantial in all instances, suggesting that brain-stem ischaemia due to vertebral artery spasm or compression had been a factor in their causation. Alternatively, differential movement between the base of the skull and the upper part of the cervical spine at the time of injury could have caused an extracranial injury to the lower cranial nerves.