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 ?
Unilateral facial nerve palsy in our case was a probable manifestation of vasculitis leading to ischemic cranial neuropathy.
4) This case and the supportive evidence from the literature would indicate the necessity of including acute seroconversion syndrome in a list of differential diagnoses for bilateral facial nerve palsy, especially in sexually active patients who have had a prior acute febrile illness with rash or headache.
Finally, this report demonstrates an extremely rare case of crossed hemiplegia with oculomotor and facial nerve palsy due to an infarct in the upper part of the midbrain as documented by the MRI scan.
The second element of the triad, peripheral facial nerve palsy, is seen in 30% to 90% of the patients with MRS that cannot be differentiated from Bell's paralysis; our patient also had experienced it about 20 years ago (10).
In the Mayo Clinic Proceedings study, 25 percent of the 1,669 patients studied experienced some type of shingles-related complication, including pain, PHN, and facial nerve palsy (paralysis).
You diagnose facial nerve paralysis and wonder about the evidence supporting the use of steroids and antivirals for improving outcomes in facial nerve palsy.
The study found no significant difference in more serious birth trauma, which included skull and clavicle fracture, intracranial hemorrhage, facial nerve palsy, and Erb's palsy (1.
Bells palsy would be the consideration of a peripheral facial nerve palsy of an LMN distribution pattern of weakness without additional neurological deficit.
During this time her major neurological deficits included a dense left hemiparesis more evident in the upper extremity, left facial nerve palsy, decreased gag, cough and swallow reflexes and left spinal accessory nerve palsy.