Facial nerve palsy Flashcards
What is it?
isolated dysfunction in the facial nerve, causing unilateral facial weakness
outline the 5 branches of the facial nerve
- temporal
- zygomatic
- buccal
- marginal mandibular
- cervical
Outline the pathophysiology of UMN v LMN lesion affecting face, in terms of appearance
Forehead has UMN innervation from BOTH sides of brain, whereas LMN innervation from only one side
therefore…
- UMN lesion= forehead SPARED
- LMN lesion= forehead NOT SPARED
What is Bell’s Palsy? Aetiology?
a unilateral lower motor neuron facial nerve palsy ; idiopathic
How does it present and how long does it last?
- Presents with unilateral facial weakness (incl forehead)
- people tend to recover over several weeks however some (1/3) are left with residual weakness
Treatment for bell’s palsy?
- Prednisolone
- Lubricating eye drops to prevent eye from drying out
Potential complication due to bell’s palsy?
If person develops pain in eye, must be referred to opthalmologist urgently- risk of Expsoure keratopathy
what is Ramsay-hunt syndrome caused by?
Herpes Zoster Virus
How does Ramsay-hunt syndrome present?
unilateral LMN facial nerve palsy, with a painful and tender vesicular rash in the ear canal, pinna or around the ear on affected side. Can also extend 2/3 down tongue and hard palate
treatment for Ramsay-hunt syndrome?
- Prednisolone
- Aciclovir
- Lubricating eye drops
Other aetiologies of LMN facial nerve palsy?
Infection
- Lyme’s Disease
- HIV
- otitis media and externa
Systemic disease:
- Sarcoidosis
- diabetes
- MS
- GBS
Tumours
- acoustic neuroma
- parotid tumours
Trauma
- direct nerve trauma, may be from surgery
- base of skull fractures
examples of conditions which may cause bilateral upper motor neuron lesions?
- pseudobulbar palsy
- motor neuron disease
