48. Facial nerve (CN VII) lesion

Question 1

Clasification

Answer 1

Supranuclear and nuclear lesions
Infranuclear lesions
Lesions may be partial or complete

Question 2

Causes

Answer 2

Infection
Trauma
Tumors
Stroke
Others: DM, Moebius Syndrome (Underdeveloped CN VII, present at birth, CNv6 also affected = no facial expression + cant move eyes side-to-side)

Question 3

Diagnosis

Answer 3

Physical exam., incl. a neurological exam.
Minimal and Maximal stimulation test (MST)
Electroneuronography (ENog)
Blood test (ESR for inflammation)
Blood sugar level (for DM)
If Trauma - CT-scan

Question 4

Treatment

Answer 4

Surgical (facial nerve decompression, soof-lift, facial nerve grafting, implantable devices placed into the eye-lids

Question 5

Symptoms

Answer 5

Facial paralysis
- Sudden (Bell’s palsy) or gradually over months (head or neck tumor)
Facial pain, headaches or dizziness
Difficulty talking
Inability to express emotion
Dysphagia or difficulty drinking
Drooling
Tearing of the eye

B4 nucleus => central damage: symptoms of opposit lower quarter, drooping of corner of mouth
After the nucleus => peripheral damage: symptoms on the same side