facial nerve palsy


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Bell’s palsy

Acute peripheral paralysis of the face due to a herpes simplex immune-mediated condition, often characterised by severe pain arising in the trigeminal nerve, the chief sensory nerve of the face, which arises in cranial nerve VII.
 
Clinical findings
Abrupt onset, drooping mouth, unblinking eye, twisted nose, uneven smile, distorted expressions; paralysis hits maximum in 1 to 14 days; retroauricular pain, facial numbness, epiphora, parageusia, decreased tearing, hyperacusis, hypoesthesia or dysesthesia of cranial nerves (CN V and IX), motor paresis of CN IX and X, papillitis of tongue.
 
Epidemiology
Risk of Bell’s palsy increases with age; age 10 to 19, 2:1 female:male ratio; age 40, 3:2 men:women ratio; pregnant women have 3.3 times increased risk than nonpregnant; DM = 4.5 times increased risk of BP; 10% of patients have positive family Hx of BP.
 
DiffDx, unilateral
Tumours or masses, otitis media, sarcoid, Lyme disease, skull fracture, facial injury.
 
DiffDx, bilateral
Guillain-Barré syndrome, Melkersson-Rosenthal syndrome, Möbius syndrome, motor neuron disease, myasthenia gravis.

Aetiology
Trauma, Bell’s palsy, stroke, parotid tumours, intracranial tumours.
 
Management
Microvascular and micro-neurosurgical tissue transfers allow restoration of functional, unconscious, symmetrical facial movements; acyclovir; steroids (uncertain efficacy); artificial tears; neuromuscular retraining—e.g., mirror/visual feedback, biofeedback or electromyography feedback.
 
Prognosis
60 to 80% recover, especially if incomplete paralysis, and patient is young.

facial nerve palsy

 Facial palsy, see there.

palsy

(pal'ze) [Fr. palesie, paralisie, fr L. paralysis, fr Gr. paralysis, loosening, disabling] Paralysis.

birth palsy

See: birth paralysis

brachial palsy

See: birth paralysis

bulbar palsy

Palsy caused by degeneration of the nuclear cells of the lower cranial nerves. This causes progressive muscular paralysis.

cerebral palsy

Abbreviation: CP
See: cerebral palsy

crutch palsy

Paralysis resulting from pressure on nerves in the axilla from use of a crutch.

diver's palsy

See: decompression illness

Erb's palsy

See: Duchenne-Erb paralysis

facial palsy

See: Bell's palsy

facial nerve palsy

See: Bell's palsy

lead palsy

Paralysis of the extremities in lead poisoning.

mercurial palsy

Paralysis induced by mercury poisoning.

night palsy

A form of paresthesia characterized by numbness, esp. at night.

peroneal nerve palsy

Paralysis of the peroneal nerve, often caused by automobile accidents in which a pedestrian's leg is injured, by fractures of the tibia, or by other occurrences of nerve disruption or compression. It produces footdrop.

pressure palsy

See: compression paralysis

progressive supranuclear palsy

A chronic progressive degenerative disease of the central nervous system that has its onset in middle age. Common symptoms include difficulty walking (with frequent falls), impairments in speech and in swallowing, and an inability to gaze upward.

Saturday night palsy

Paralysis due to prolonged ischemia of the musculospiral nerve incident to compressing an arm against a hard edge. It occurs if the patient has been comatose or in a stupor or has fallen asleep with the arm hanging over the edge of a bed or chair. In some cultures individuals traditionally become intoxicated on Saturday night; while stuporous, they may remain in a position that allows nerve compression.
Synonym: musculospiral paralysis; radial paralysis; Saturday night paralysisSunday morning paralysis

scrivener's palsy

See: writer's cramp

shaking palsy

An archaic term for Parkinson's disease.

wasting palsy

See: spinal muscular atrophy
References in periodicals archive ?
Uveitis, salivary gland swelling, and facial nerve palsy in a febrile woman.
Etiologies of facial nerve palsy * Ischemic stroke of the pons * Intraparenchymal hemorrhage of the pons * Herpes simplex virus-associated Bell's palsy * Human immunodeficiency virus * Lyme disease * Varicella zoster virus-associated Ramsay-Hunt syndrome * Sarcoidosis * Tuberculosis * Adenocarcinoma * Lymphoma * Sjogren's syndrome * Systemic lupus erythematosus
Although we could not rule out the possibility that our patient's disease entity was Bell palsy with an incidental finding of a cystic lesion in the temporal bone, the imaging studies--CT and MRI scans of the temporal bone--provided beneficial information on the diagnosis and treatment of facial nerve palsy in our patient.
Facial nerve palsy, swallowing problems and hoarseness may occur if cranial nerves are involved.
In the presence of facial nerve palsy, decompression is not indicated.
In addition to the left facial nerve palsy, a deficit was noted in the ipsilateral VIIIth nerve.
There was no history of otorrhea, bleeding, vertigo, or facial nerve palsy.
A pattern of fever, uveitis, parotitis, and facial nerve palsy is known as Heerfordt's syndrome.
In this article, we describe such a case, which also featured facial nerve palsy on the opposite side.
A 70-year-old Asian man with noninsulin-dependent diabetes was referred to our ENT clinic with a 4-month history of left-sided otitis externa and right-sided lower motor neuron facial nerve palsy.
2) Several cases of retropharyngeal abscess secondary to tuberculosis of the cervical vertebrae have been reported, (11-14) but to the best of our knowledge, there has been no previous report of a retropharyngeal tuberculous abscess (1) with a cutaneous abscess and facial nerve palsy and (2) without involvement of the cervical vertebrae.