Facial nerve paralysis
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| Moche. Culture Representation of Facial Paralysis. 300 A.D. Larco Museum Collection, Lima, Peru. |
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Facial nerve paralysis Microchapters |
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Case Studies |
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Facial nerve paralysis On the Web |
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American Roentgen Ray Society Images of Facial nerve paralysis |
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Risk calculators and risk factors for Facial nerve paralysis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]; Template:GCC
Overview
Facial nerve paralysis and Bell's palsy is due to a loss of voluntary movement of the muscles on one side of the face due to abnormal function of the facial nerve(s). A Peripheral palsy affects all ipsilateral muscles of facial expression (paralysis results on the entire ipsilateral side). A supranuclear palsy involves the lower part of the face.
Facial nerve paralysis is a common problem that involves the paralysis of any structures innervated by the facial nerve. The pathway of the facial nerve is long and relatively convoluted, and so there are a number of causes that may result in facial nerve paralysis. The most common is Bell's palsy, an idiopathic disease that may only be diagnosed by exclusion.
A thorough medical history and physical examination are the first steps in making a diagnosis.
During the physical examination, a distinction must first be made between paralysis and paresis (incomplete paralysis). Not surprisingly, paralysis is far more serious and requires immediate treatment. It must also be determined whether the forehead is involved in the motor defect or not. This is usually accomplished by assessing how well a patient can raise her eyebrows. The question is an important one because it helps determine if the lesion is in the upper motor neuron component of the facial nerve, or in its lower motor neuron component.
Laboratory investigations include an audiogram, nerve conduction studies (ENoG), computed tomography (CT) or magnetic resonance (MR) imaging.
Laboratory Findings
MRI and CT
Treatment
- Massage of weakened muscles, tape eye and use eye shield during sleep and possible electrical stimulation of paralyzed muscles (Bell's palsy)
- Treat underlying disease etiologies
- Consider neurologic referral
Pharmacotherapy
- Corticosteroids and IV acyclovir for Bell's palsy
References
Additional Resources
- Acute facial nerve paralysis - Powerpoint slides from a lecture presented to second year medical school students at the University of Western Ontario by Dr. Lorne Parnes on 19 November 2004. These notes are licensed under the FDL.
- Acute facial nerve paralysis - Notes from a lecture presented to second year medical school students at the University of Western Ontario by Dr. Lorne Parnes on 19 November 2004. These notes are licensed under the FDL.
Template:PNS diseases of the nervous system
de:Fazialislähmung hr:Kljenuti ličnog živca no:Facialisparese