There are 12 pairs of cranial nerves that can be affected by the brain sag caused by spinal cerebrospinal fluid (CSF) leak. Some cranial nerves are affected more commonly than others.
Here are some of common symptoms, and the cranial nerves associated with them:
- Visual blurring; visual field defects
2nd cranial nerve - Diplopia (double vision)
3rd, 4th and 6th cranial nerves - Hearing changes (phonophobia, muffled hearing, tinnitus)
8th cranial nerve; another mechanism may be changes in fluid levels in inner ear - Facial numbness or pain
5th cranial nerve - Facial weakness or paralysis
7th cranial nerve - Sense of imbalance; unsteady gait
8th cranial nerve; other mechanisms also - Dizziness; vertigo
8th cranial nerve; also pressure changes in inner ear fluid - Changes in sense of taste
1st, 7th, or 9th cranial nerves - Pain in throat or palate
9th cranial nerve - Changes in sense of smell
1st cranial nerve - Dry mouth
7th or 9th cranial nerve
Dr. Deborah Friedman discussed cranial nerve involvement in SIH at the Intracranial Hypotension Symposium in February 2020.
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