Facial Palsy: Difference between revisions
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Causes of Facial Palsy:<br> | Causes of Facial Palsy:<br> | ||
*Idiopathic/viral | |||
Bell's Palsy (linked to Herpes Simplex infection) | |||
* | Ramsey Hunt Syndrome (linkied to Herpes Zoster infection) | ||
*Tumour | |||
A tumor compressing the facial nerve can result in facial paralysis, but more commonly the facial nerve is damaged during surgical removal of a tumour. The most common tumour to result in facial palsy during surgical removal is the Acoustic Neuroma (AKA Vestibular Schwannoma). Less commonly, cholesteatoma, hemangioma, Facial Neuroma or partotid gland tumours are the cause. | |||
*Rare causes include | |||
Neurosarcoidosis, ototis media, Multiple Sclerosis, Moebius Syndrome | |||
*The facial nerve can also be damaged by trauma, especially temporal bone fractures | |||
== Clinical Presentation == | == Clinical Presentation == |
Revision as of 18:02, 10 September 2013
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Clinically Relevant Anatomy
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Mechanism of Injury / Pathological Process
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Causes of Facial Palsy:
- Idiopathic/viral
Bell's Palsy (linked to Herpes Simplex infection)
Ramsey Hunt Syndrome (linkied to Herpes Zoster infection)
- Tumour
A tumor compressing the facial nerve can result in facial paralysis, but more commonly the facial nerve is damaged during surgical removal of a tumour. The most common tumour to result in facial palsy during surgical removal is the Acoustic Neuroma (AKA Vestibular Schwannoma). Less commonly, cholesteatoma, hemangioma, Facial Neuroma or partotid gland tumours are the cause.
- Rare causes include
Neurosarcoidosis, ototis media, Multiple Sclerosis, Moebius Syndrome
- The facial nerve can also be damaged by trauma, especially temporal bone fractures
Clinical Presentation[edit | edit source]
Paralysis of the muscles supplied by the Facial Nerve presents on the affected side of the face as follows:
Appearance and range of movement:
Inability to close the eye
Inability to move the lips eg. into smile, pucker
At rest, the affected side of the face may "droop"
Functional effects:
Difficulty eating and drinking as lack of lip seal makes it difficult to keep fluids and food in the oral cavity
Reduced clarity of speech as the "labial consonents" (ie. b, p, m, v, f) all require lip seal
Differential Diagnosis:
If the forehead is not affected (ie the patient is able to raise fully the eyebrow on the affected side) then the facial palsy is likely to be a result of a lesion in the Upper Motor Neuron. Paralysis which includes the forehead, such that the patient is unable to raise the affected eyebrow, is a Lower Motor Neuron lesion.
Diagnostic Procedures[edit | edit source]
Laboratory investigations include an audiogram, nerve conduction studies (ENoG), computed tomography (CT) or magnetic resonance imaging (MRI), electromyography (EMG).
Outcome Measures[edit | edit source]
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Management / Interventions
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Differential Diagnosis
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Resources
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