Facial nerve palsy Flashcards
What motor function does the facial nerve have?
Facial expression
Stapedius in the inner ear
Posterior digas)tric (aids in swallowing and jaw movement, stylohyloid and platysma muscles
What sensory function does the facial nerve have?
Taste from anterior 2/3 of tongue
What parasympathetic function does the facial nerve have?
Submandibular and sublingual salivary glands
Lacrimal gland - tear production
What is the difference between upper and lower motor neurone facial palsies?
Upper - forehead is spared as has bilateral supply from the brain
Lower - forehead NOT spared as only has supply from one side
What are causes of unilateral upper motor neurone lesions?
STROKE
TumoursW
What are causes of bilateral upper motor neurone lesions?
Pseudobulbar palsies
MND
What causes Bell’s palsy?
Idiopathic
How does Bell’s palsy present?
Unilateral lower motor neurone facial nerve palsy:
Forehead affected
Post-auricular pain
Altered taste
Dry eyes
Hyperacusis - can’t tolerate noise as well
What is the treatment of Bells palsy ?
Prednisolone if presenting within 72 hours of symptoms
Lubricating eye drops to prevent eye damage and exposure keratopathy
Taping eye shut at night
What causes Ramsay-Hunt syndrome
Varicella Zoster virus
How does Ramsay hunt present
Vesicular rash tat is painful in the ear canal, pinna and ear.
This can extend to the anterior two thirds of the tongue and the hard palate
What is treatment of Ramsay hunt
Aciclovir
Prednisolone
What are infectious causes of lower motor neurone facial nerve palsies
Otitis media
otitis externa
HIV
Lyme disease
What are systemic diseases that can cause lower motor neurone facial nerve palsies
Diabetes
Sarcoidosis
Leukaemia
MS
Guillain Barre
What tumours can cause lower motor neurone facial nerve palsies?
Acoustic neuromas
Parotid tumour
Cholesteatoma
