MRCP PACES Multiple Cranial Neuropathies Jugular Foramen Syndrome
  • CN IX, X and XI exit through the jugular foramen together with the internal jugular vein
  • Symptoms and signs:
    • Ipsilateral reduced / absent gag reflex
    • Ipsilateral reduced soft palate elevation
    • Deviation of uvula away from the side of the lesion
    • Dysphagia, dysphonia, dysarthria
    • Bovine cough
    • Weakness of shoulder shrugging
    • Weakness in turning head to the opposite side (ride sternocleidomastoid turns head left)
  • Causes:
    • Glomus tumour (jugular bulb – glomus jugulare, vagus – glomus vagale)
    • Schwannomas
    • Meningiomas
    • Retroparotid abscesses
    • Thrombosis of jugular bulb
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