Facial palsy

Question 1

describe the cranial portion of the facial nerve

Answer 1

leaves brainstem at PMJ and CPA

enters IAM

Question 2

describe the temporal portion of the facial nerve

Answer 2

travels through the temporal bone and near middle ear through the facial canal
leaves through stylomastoid foramen

Question 3

describe the extra temporal region of the facial nerve

Answer 3

goes towards the facial muscles splitting into 6 branches

Question 4

which muscle in the middle ear does the facial nerve innervate

Answer 4

stapedius

Question 5

what is the chorda tympani

Answer 5

branch of the facial nerve that conveys taste in the anterior 2/3rds of the tongue
as well as parasympathetics to the submandibular/lingual glands

Question 6

what are the modalities of the facial nerve

Answer 6

parasympathetic
special sensory
somatic motor
somatic sensory

Question 7

symptoms of facial palsy

Answer 7

facial muscle weakness
dry eyes, mouth + mucosa
lack of taste in ant 2/3rd tongue

Question 8

causes of facial palsy

Answer 8

stroke 
vestibular schwannoma / meningioma (rarely facial palsy alone)
Bells palsy 
Ramsey Hunt syndrome
acute otitis media 
necrotising otitis externa 
cholesteatoma 
trauma - blunt or penetrating
surgery 
parotid pathology (malignancy)
systemic

Question 9

facial palsy in stroke/UMN is forehead sparing/involving?

Answer 9

sparing

due to bicortical representation

Question 10

what is the commonest cause of facial palsy

Answer 10

Bells palsy

Question 11

what is Bells palsy

Answer 11

idiopathic 
diagnosis of exclusion 
potentially viral 
onset over a few hours 
managed with high dose short course steroids

Question 12

what is Ramsey Hunt syndrome

Answer 12

VZV/shingles of the facial nerve

Question 13

function of greater petrosal nerve

Answer 13

lacrimal gland
if damaged leads to dry eye
arises at geniculate ganglion

Question 14

symptoms of Ramsey hunt

Answer 14

rash in external ear skin / conch 
eye 
soft palate
facial palsy 
hearing loss