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Neurologic Conditions > Facial Weakness > Flashcards

Facial Weakness Flashcards

1
Q

What are the sx of Bell’s Palsy?

A
  • Acute onset of unilateral facial weakness
  • Pain around or behind ear
  • Inc sensitivity to sound ipsi
  • Paresthesia of face ipsi
  • Dec taste sensation
  • Dry eye ipsi
  • Very rarely bilateral
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2
Q

What can precede Bell’s Palsy?

A

URI

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3
Q

What will be found on PE in Bell’s Palsy?

A
  • Unilateral facial weakness (upper & lower face)
  • Cannot close eye tightly ipsi
  • Speaking & chewing pose difficulties
  • Dec efferent limb component of the corenal reflex
  • Dry eye
  • Sensation normal
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4
Q

What are the technological features of Bell’s Palsy?

A

NONE

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5
Q

What causes Bell’s Palsy?

A

Viral infection of the facial nerve

HSV MC

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6
Q

What is the tx of Bell’s Palsy?

A

Supportive & watchful waiting

80-90% of pts obtain 80-100% improvement in 3mo

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7
Q

What is the management for Bell’s Palsy?

A
  • Artificial tears for dry eyes
  • Eye patch to preven corenal abrasions during sleep
  • MRI if no improvement in 1 mo
  • Botulinum toxin injections if pt dev facial dyskinesias
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8
Q

What is the hx of Facial weakness d/t cerebral hemisphere lesion?

A
  • Acute in stroke
  • Subacute or chronic in mass lesions such as abscess or tumor
  • Sensory or motor complaints on the ipsi side of body
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9
Q

What are the PE findings of Facial weakness d/t cerebral hemisphere lesion?

A
  • Weakness confined to lower half of face
  • Wrinking in forehead uneffected
  • Efferent limb component of corneal reflex is unaffected
  • Freq signs of UMN weakness or ipsi body
  • Freq ipsi body & facial sensory deficit
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10
Q

What are the Technological findings of Facial weakness d/t cerebral hemisphere lesion?

A
  • MRI w/ & w/o contrast is the best test
  • CT scan w/ & w/o contrast is the next best
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11
Q

Where does the lower half of the facial nerve receive UMN control?

A

Contralateral hemisphere

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12
Q

Where does the upper half of the facial nerve receive UMN control?

A

BOTH hemispheres

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13
Q

What is the tx of Facial weakness d/t cerebral hemisphere lesion?

A

Diet modification & speech/swallow therapy since they they have Dysarthria & chewing problems

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14
Q

What does Dysarthria & chewing issues inc risk for?

A

Aspiration

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15
Q

What are the sx of Facial weakness d/t Brainstem lesion?

A
  • Facial weakness
  • CN sx
  • Sensory sx
  • Weakness
  • Disequilibrium or ataxia
  • Dysarthria or Dysphagia
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16
Q

What are the PE findings of Facial weakness d/t brainstem lesions?

A
  • Facial weakness of upper & lower face
  • CONTRA UMN body weakness
  • Dysarthria & dysphagia (maybe)
  • Ataxia & dysequilibrium (maybe)
17
Q

What is the most sensitive imaging for brainstem lesions?

A

Brain MRI scanning

Neurologic Conditions (15 decks)

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