facial nerve paralysis

By:

Sakar S.Hassan

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.

Supranuclear and nuclear lesions

Infranuclear lesions:

a. Bell’s palsy

b. Moebius syndrome

c. Acute and chronic otitis media

Multiple

a. Trauma

b. Tumors

Clinical features

• Facial asymmetry• Eyebrow droop• Loss of forehead &

nasolabial folds• Drooping of corner of mouth• Uncontrolled tearing• Inability to close eye• Lips not held tightly together: Difficulty keeping

food in mouth• Facial muscle atrophy (Late)

An idiopathic sudden onset of

facial paralys,is the most common

cause of acute facial nerve paralysis

(>80%).it has been recently linked to

herpes simplex infection.Other conditions that may cause Bell's palsy include:

HIV infection

Lyme disease

Middle ear infection

Sarcoidosis

Patients who develop Bell’s palsy fall into three groups:

1. 85% of individuals completely recover from the Bell’s palsy.

2. 10% of individuals have partial facial weakness.

3. 5% of the patients have complete facial paralysis

OnsetParalysis: Progresses to maximal deficit over 3 to 72 hours

Pain (50%): Near mastoid process

Excess tearing (33%)

Other: Hyperacusis; Dysgeusia

Sudden weakness or paralysis

on one side of face that

causes it to droop.

Drooling.

Eye problems, such as

excessive tearing or a dry eye.

Loss of ability to taste.

Pain in or behind ear.

Numbness in the affected side of face.

Increased sensitivity to sound.

Primary viral infection (herpes)

Early treatment (within 3 days after the onset) is necessary for therapy to be effective.

Steroid: Corticosteroid such as prednisone

Antiviral :(such as acyclovir)

Surgery

Physiotherapy

Facial exercises.

Eye care. A dry eye can lead to sores and serious vision problems. To help protect the eye and keep it moist:

Use your finger to close and open your eyelid often throughout the day.

Use eye drops ("artificial tears") or ointment.

Wear an eye patch , and wear glasses.

Mouth care. Brush and floss your teeth often and eat soft foods.