facial nerve palsy

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.