Facial nerve palsy

Question 1

Branches of the VIIth nerve from the parotid

Answer 1

two zombies buggered my cat

temporal
zygomatic
buccal
mandibular
cervical

Question 2

Causes of facial nerve palsy (3)

Answer 2

Intracranial:

• brainstem tumours
• stroke
• MS
• cerebellopontine angle lesion (acoustic neruoma, meningitis)

Intratemporal:

• otitis media
• ramsay-hunt(VZV)
• cholesteatoma
• parotid tumours
• trauma

Other:

• sarcoid
• GBS
• diabetes
• lyme disease
• herpes
• bell’s

Question 3

Features of facial nerve palsy (5)

Answer 3

unilateral facial weakness

dry eyes

hyperacusis

post-auricular pain

altered taste

Question 4

Examinations and test for facial nerve palsy (6)

Answer 4

LMN>can’t scrunch forehead

UMN> can scrunch forehead

cranial nerves:

• scrunch eyes and resist
• raise eyebrows and resist
• blow cheeks and resist
• smile and show teeth

Question 5

Mx of Bell’s palsy (2)

Answer 5

(idiopathic condition)

protect eyes:

• glasses
• tape shut when asleep
• lateral tarsorrhaphy if present for long time
• artificial tears

prednisolone w/i 72h to reduce oedema and help recovery.