Bilateral lower cranial nerve palsy after closed head injury
Paralysis of the lower cranial nerves is uncommon after closed head injuries. Most cases reported are unilateral and associated with base of skull fractures, usually involving the occipital condyles.

Published in the Indian Journal of Critical Care Medicine, the authors present a rare case of bilateral lower cranial nerve palsy which is even less common, with only a handful of cases reported in literature.

A 17-year-old girl presented after she was involved in a side-on collision with a car while driving a scooter. She sustained traumatic brain injury requiring mechanical ventilation. Detailed neurological evaluation revealed bilateral paralysis of the IXth, Xth, and XIIth cranial nerves with no evidence of a fracture of the base of skull or brain stem injury.

This patient made a complete recovery over a period of 4 months.

Learning Points:-

- A traction type of injury to the nerves arising from a whiplash mechanism may have led to paralysis of the lower cranial nerves in this patient.

- This type of injury may be associated with a favorable outcome.

Read in detail here: