This document discusses facial palsy, also known as Bell's palsy. It is a condition that causes partial or complete paralysis of the facial nerve resulting in drooping of the facial muscles. The document outlines the types of facial palsy as central or peripheral, and the potential causes such as idiopathic (Bell's palsy), trauma, infection, tumors, or Guillain-Barre syndrome. Signs and symptoms, diagnostic tests like EMG and imaging, and treatment options including corticosteroids, antivirals, and eye care are summarized. The prognosis is generally good with 85% of idiopathic cases fully recovering within 3 weeks, but recovery can take longer or be incomplete

3. • Palsy :- Complete or partial muscle paralysis, often
accompanied by loss of sensation and uncontrollable body
movements or tumors.
• Paresis :- Muscular weakness
• Paralysis :- Complete loss of muscle function
• Facial palsy :- Loss of facial movement due to nerve
damage.

4. • It is a neurological condition in which function
of facial nerve (cranial nerve VII) is partially or
completely lost.
• It may appear to droop to become weak.
• Affect one or both side of face.

7. Types
of facial
palsy
Central
facial
palsy
Peripher
al facial
palsy

9. • Lesion occurs between
cortex and nuclei in the
brain stem.
• Manifest with
impairment of the lower
contralateral mimic
musculature.

10. • Lesion occurs between
nuclei in the brainstem
and peripheral organs. It
leads to impairment of the
ipsilateral mimic muscles
and also affects the
eyelids and forehead.
• Cause various sensory
and autonomic disorders (
depending on the exact
location of the lesion).

12.  Idiopathic (50% of cases) – acute idiopathic
peripheral facial palsy- known as Bell palsy.
 Secondary :-
• Trauma – Temporal bone fracture
• Infection :- HZV (Herpes zoster virus), borreliosis, HSV
(Herpes simplex virus), HIV infection
• Tumors
• Pregnancy
• Diabetes mellitus
• Guillain – Barre syndrome
• Sarcoidosis
• Amyloidosis
• Stroke

15. Sign & Symptoms
• Sudden onset symptoms usually in hours, maximal weakness
in 48 hrs.
• Unilateral
• Eyebrow sagging
• Inability to close eye
• Loss of nasolabial fold
• Decreased tearing
• Hyperacusis
• Loss of taste to anterior 2/3 tongue.
• Mouth droop

16. Eyebrow sagging
Nasolabial fold

17.  Physical examination :- To move facial muscles by closing
eyes, lifting brow, showing teeth and frowning and other
movements.
 EMG ( Electromyography) :-
 To confirm the presence of nerve damage and determine its
severity.
 It measures the electrical activity of a muscle in response to
stimulation and the nature and the speed of the conduction of
electrical impulses along a nerve.
 Imaging – CT , MRI
 To rule out other possible sources pressure on the facial nerve,
such as tumor or skull fracture.

19. EMG
CT MRI

20.  Corticosteroids – Prednisone
• powerful anti-inflammatory agent
• Reduce the swelling of the facial nerve.
 Anti-viral drugs
• It added to steroids are possibly beneficial for some people with
Bell’s palsy, but this is still unproved.
 In severe cases
 Valacyclovir- for 1 week
 Eye care with – artificial tears

21.  Traumatic facial nerve palsy
 surgical decompression or nerve repair
 In the past, Decompression surgery was used to relieve the
pressure on the facial nerve by opening the bony passage that
the nerve passes through.
 Today isn’t recommended.
 Facial nerve injury and permanent hearing loss are possible
risks associated with this surgery.

22. • Idiopathic facial palsy- complete recovery in-
85%of cases( within 3 weeks)
• If motor nerve conduction studies show evidence
of denervation after 10 days indicates prolonged
recovery of – 3 months and possible incomplete
recovery.

23. • Dural tears
• Conductive or sensory neural hearing loss
• Vestibular function loss
• Persistent CSF leaks
• Meningitis
• Injury to the anterior inferior cerebellar artery
(AICA) or its branches.