Read more about this disease, some with Classification – Types – Signs and symptoms – Genetics – Pathophysiology – Diagnosis – Screening – Prevention – Treatment and management – Cures and much more, some including pictures and video when available.
Facial nerve paralysis is a common problem that involves the paralysis of any structures innervated by the facial nerve. The pathway of the facial nerve is long and relatively convoluted, and so there are a number of causes that may result in facial nerve paralysis. The most common is Bell’s palsy, an idiopathic disease that may only be diagnosed by exclusion.
A thorough medical history and physical examination are the first steps in making a diagnosis.
During the physical examination, a distinction must first be made between paralysis and paresis (incomplete paralysis). Not surprisingly, paralysis is far more serious and requires immediate treatment. It must also be determined whether the forehead is involved in the motor defect or not. This is usually accomplished by assessing how well a patient can raise her eyebrows. The question is an important one because it helps determine if the lesion is in the upper motor neuron component of the facial nerve, or in its lower motor neuron component.
Laboratory investigations include an audiogram, nerve conduction studies (ENoG), computed tomography (CT) or magnetic resonance imaging (MRI).
Bell’s palsy is the most common cause of acute facial nerve paralysis (>80%). Previously considered idiopathic, it has been recently linked to herpes simplex infection. Another more severe form of facial palsy, called Ramsay-Hunt syndrome, is linked to herpes zoster infection of the facial nerve. Other, less common, etiologies are Lyme disease) polio, TB..
Bell’s palsy is an exclusion diagnosis. Some factors that tend to rule out Bell’s palsy include:
Bell’s palsy is believed in the most recent studies to be due to herpes virus. Other proposed etiologies include vascular problems in the inner ear. Treatment include steroids and antivirals.
[tubepress mode=’tag’, tagValue=’Facial nerve paralysis’]