Facial Nerves: Disorders Flashcards
Male 5 yo px come white acute unilateral facial paralsisis with no antecedents of infections, can´t move mid-face, has minimun hearing loss and dissnezz retro-auricular pain , toung and taste are afected.
has Family history of facial paralisis & dm.
what are you dx suspect?
Whats the study would ypu make him?
whats the tx whould you prescribs?
Bell-Palsy
Dx confimed with: Electroneuronography + electromyography
Tx: Corticosteroids - Prednisolona 60mg 72h (Desescalar 10mg diarios) despues de los 3 dias.
a niños a Urgencia
60 yo px come with unilateral right facial palsy, has acute hear pain with vasicular eruption on ipsilateral (right) ear, with tinitus and hearing loss (right).
Dx , whts the etiology cause virus?
Tx
Se puede dañar los nervios X, IX y X
Sx Ramsay Hunt
Varicela Zoster is the etiological virus.
Tx: Aciclovir
#Rara vez hay otalgia.
Lo mejor es observar el conducto auditivo y el pabellon auricular.
What are the most important (3) Etiologys of Facial Paralisis?
1° Viral Infections: Bell(Herpes Simple) | Sx Ramsay Hunt (Varicela Zoster). Others: Ebstein Bar… etc
2° Isquemic Valvulopaty
3° Inmunodeficience (Steroids, Antibiotics, VIH, Hight DM) La más comun es tipo 3 Autoinmune.
Whats the Most place damage on a Bell Palsy?
Labyrinthine. (Lugar de daño afectado)
At isquemic Etiology of Facial Palsy what are the arthery relationates (3)
Labeyrintic Artery (Proximal).
Middle Meningeal Artery (Central).
Stylomastoid artery (Distal).
Risk Factors to have Facial Palsy?
Young Woman (Most Commt)
Older Man (Most Communt)
DM, VIH, Pregnazy (Embarazada en 3rtrimestre o en Preclamsia)
Whats the other alternative for facial Palsy?
Non Surgical
Electro stimulation
or cx
On a case of a Nerve Grafting (Conjugar para reinervación) whats the nerve grafting with?
Hypoglossal + peripheral facial(VII) Nerve
Whats the other surgical skills you make have with?
at children
On children you might Uso Prenisolone low dosis or Reconstruction terapy
Px who has mid face paesis + headache (Migraña)+ Lingua plicada (:P) + episodic face edema .
Whats the dx? and triplle tx
Sx Melkersson Rosenthal
Steroid + Descompresion + Adalinumab
On a Summer (Verano) a px got rash on his skin, then erytema migrands (en forma de diana) after 7 days got bilateral facial palsy
On a serologic study you see: IgM or IgG
Dx & Tx?
Tx acording if is and Adult or Child
Lime Desease (Mordedura por Chagas)
Child –> Peniciline
Man –> Tetracicline
Alternative: Erytromicine
Otros tipos de Paralsis facial: Signos
a) AOM + Mastoiditis (Sintomas asociados por cronicidad)
b)Perinatal Facial Palsy (Cara de bebé)
c)Sx Mobius (No tiene nervio VII u otros)
a) Otorrea, retroauricular pein, fever, hearing loss
b) deformación del rn al llorar
c) Inexpresión facial bilateral.
