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 ?
Facial nerve palsy and erosion of vital intratemporal structures can occur as a result of pressure erosion of the bony EAC and adjacent structures.
Sarella et al [8] reported one case of facial nerve palsy during third trimester of pregnancy.
In addition to malignancy, autoimmune conditions such as granulomatosis with polyangiitis and sarcoidosis and immunodeficiency conditions should also be considered in the differential diagnosis of cases of refractory chronic otitis media with facial nerve palsy. Delay in management of such cases usually occurs due to a low index of suspicion of the treating physician.
Differential diagnosis of facial nerve palsy. Otolaryngol Clin North Am.
Botulinum toxin to improve lower facial symmetry in facial nerve palsy. Eye (Lond).
HBS has been mostly widely used in studies of peripheral facial nerve palsy in recent years.
The infant was clinically diagnosed to have facial nerve palsy on the left side.
Before concurrent radiotherapy and chemotherapy, a total parotidectomy is recommended as a treatment for metastasis of parotid glands in literature because facial nerve function may not be preserved well enough under unsatisfactory locoregional control; on the other hand, if the facial nerve has been involved in a metastatic NPC lesion of parotid glands, radiotherapy deserves consideration before surgery because more or less postoperative facial nerve palsy might be inevitable after surgical intervention.
It can also be used to treat issues related to facial nerve palsy and abnormal facial nerve regeneration, which can cause problems such as abnormal tears or sweating.
Marked athetoid writhing of the trunk, arms and legs - worse distally and with eyes closed, disappearing while asleep; an ataxic, wide-based gait with left foot drop (power 2/5); a complete right peripheral facial nerve palsy; right-sided fixed-flexion deformity of the first, third and fourth digits and fixed extension of the wrist (Figure 1); anaesthesia of the lower limbs to the level of the mid-tibia, with preservation of sensation on the dorsum of the right foot and loss of proprioception and vibration in the upper limbs to the elbow and in the left lower limb to the knee.
Physical treatment of peripheral facial nerve palsy comprises superficial heat therapy (hot pack or infrared), electrical stimulation, massage, exercise, and biofeedback training.