Tuesday, July 20, 2010

Vertigo, TMJ and Sleep Apnea connection

There is a place where your skull, jaw and neck meet just behind your earlobe. If you poke there gently, you may find that it is sensitive and maybe painful. This is the anatomical location where cranial nerves 9, 10, 11, and 12 can get irritated and cause many symptoms. Nearby there are muscles that can squeeze cranial nerve 7 and 8.

A closer look at where those nerves go and what functions are affected is very interesting.

Cranial nerves 9 and 10 go to the pharyngeal muscles-these are the muscles that flap around if we snore. If they are weak the airway gets smaller and we get less oxygen into our bodies with each breath. These are the muscles that are implicated in obstructive sleep apnea. Decreased oxygen saturation in the body during sleep causes a slight panic reaction that causes clinching and grinding the teeth known as bruxism.

Bruxism damages the teeth leading to stress fractures and possible loss of the teeth. It can damage the TMJ-temporomandibular joint leading to jaw pain, headaches, dizzyness and neck pain.

Decreased oxygen saturation can cause the heart rate and blood pressure to increase. Sometimes this can happen suddenly and the rapid rise in pulse and blood pressure produces a rebound suppresion of heart rate and blood pressure. The sudden drop in cardiac output can cause a person to feint. This is called syncope or vasovagal response. By the way cranial nerve 10 is also known as the vagus nerve.

CN 10 - The vagus nerve has multiple functions throughout the body. It an affect sleep, digestion, and your sex life. Also...it can make you feint. Oh and branches from CN 9 go to the carotid artery and can raise your blood pressure.

CN 12 goes to the tongue and in severe cases of sleep apnea thae tongue falls back and can close the airway completely. CN 11 goes to the SCM and Trapezius muscles that stabilize the head into the proper position.

If CN 7 is irritated it can produce paralysis of the face as in Bell's palsy. In Bell's palsy, half of the face can get weak and/or paralized. CN 8 affects the ear for hearing and balance. Irritation to CN 8 is commonly related to vertigo, tinnitus, and hearing loss. If you have all three then you can be diagnosed with Meniere's syndrome.

One cranial nerve that is affected is CN 5 which connects the chewing muscles with the uppermost nerves of the neck. It can cause Trigeminal Neuralgia, a very painful syndrome of facial pain.

The crushing and irritation of these cranial nerves can cause degradation of the nerve function and produce a myriad or constellation of symptoms. Symptoms that may not seem to berelated until we understand the proximity and function of the nerves.

Symptoms such as migraine headaches, vertigo, TMJ syndrome, sleep apnea, ringing in the ears, difficulty swallowing, digestive problems, anxiety, neck pain and back pain can all bea caused by pressure on these cranial nerves.

A proper history and examination can help determine if the cranial nervs are involved. A proper treatment plan can be implemented to correct the problems.

Mo Shouka, DC, QME

1 comment:

  1. do you have a dr in DC that can do what you do...