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Facial Nerve Paralysis Causes


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41. Facial palsy

therapy (with or without anti-viral) most improvement occurs within three weeks Other causes of paralysis of the facial nerve, which are not addressed in this Clinical Management Guideline, include: infection, e.g. otitis media trauma, e.g. temporal bone fracture tumour compressing the facial nerve, e.g. acoustic neuroma sarcoidosis Guillain-Barré syndrome cerebrovascular accident (stroke) Predisposing factors Bell’s Palsy is more common in: pregnancy (annual incidence increases to 45 per 100,000 (...) ). Cochrane Database Syst Rev. 2016;7:CD001942 Gagyor I, Madhok VB, Daly F, Somasundara D, Sullivan M, Gammie F, Sullivan F. Antiviral treatment for Bell's palsy (idiopathic facial paralysis). Cochrane Database Syst Rev. 2015;11:CD001869 Lay summary Facial palsy results if the nerve supplying the muscles of the face, including the circular muscle around the eye, stops functioning. There are many causes, but Bell’s Palsy is the commonest, accounting for nearly three quarters of all cases. Usually

2018 College of Optometrists

42. Anesthesia mumps resulting in temporary facial nerve paralysis after the auditory brainstem implantation in a 3-year-old child. (PubMed)

Anesthesia mumps resulting in temporary facial nerve paralysis after the auditory brainstem implantation in a 3-year-old child. An acute transient sialadenitis of the major salivary glands in the early postoperative period is called 'anesthesia mumps'. It has been reported in different surgical procedures especially in neurosurgical procedures. Anesthesia mumps develops very fast after the extubation period but it usually regresses with no sequelae within a few hours. However, sometimes serious (...) complication can occur such as respiratory distress. In this report, we present a 3-year-old girl with an anesthesia mumps and facial palsy occurring after successful auditory brainstem implantation and we discuss the cause and the management of this rare complication in this report. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

2013 International Journal of Pediatric Otorhinolaryngology

43. WITHDRAWN: Corticosteroids for Bell's palsy (idiopathic facial paralysis). (PubMed)

WITHDRAWN: Corticosteroids for Bell's palsy (idiopathic facial paralysis). Inflammation and oedema of the facial nerve are implicated in causing Bell's palsy. Corticosteroids have a potent anti-inflammatory action which should minimise nerve damage and thereby improve the outcome of patients suffering from this condition.The objective of this review was to assess the effect of steroid therapy in the recovery of patients with Bell's palsy.We searched the Cochrane Neuromuscular Disease Group (...) concealment was appropriate in two trials, and the data reported allowed an intention-to-treat analysis. The data included in the meta-analyses were collected from three trials with a total of 117 patients. Overall 13/59 (22%) of the patients allocated to steroid therapy had incomplete recovery of facial motor function six months after randomisation, compared with 15/58 (26%) in the control group. This reduction was not significant (relative risk 0.86, 95% confidence interval 0.47 to 1.59). The reduction

2009 Cochrane

44. Assessment of cranial nerve mononeuropathy

with paralysis of adduction, elevation, and depression, and when the pupil is involved a large unreactive pupil is noted. This presentation can suggest serious neurological disorders, namely subarachnoid haemorrhage, cerebral aneurysms, uncal herniation, or meningitis, so prompt recognition and evaluation is needed. The fourth cranial nerve innervates the superior oblique muscle, which controls depression, intorsion, and adduction of the eye. It is the most common cause of vertical diplopia. The frequency (...) of fourth nerve palsy is difficult to report accurately, but in one large series it was more common than both oculomotor and abducens palsies. Holmes JM, Mutyala S, Maus TL, et al. Pediatric third, fourth, and sixth nerve palsies: a population-based study. Am J Ophthalmol. 1999;127:388-392. Richards BW, Jones FR Jr, Younge BR. Causes and prognosis in 4,278 cases of paralysis of the oculomotor, trochlear, and abducens cranial nerves. Am J

2018 BMJ Best Practice

45. Epidemiologic Overview of Synkinesis in 353 Patients with Longstanding Facial Paralysis under Treatment with Botulinum Toxin for 11 Years. (PubMed)

synkinesis. Ten patients presented with both types.This study determined the high prevalence (55.5 percent) of synkinesis in patients with longstanding facial paralysis. Postparalysis synkinesis was positively associated with infectious and idiopathic causes, electrical stimulation, facial nerve decompression, and no requirement for surgery. Postreanimation synkinesis was present in 28.2 percent of reanimated patients and was significantly associated with microsurgical flaps, transfacial nerve grafting (...) analyzed.There was a significant association between cause and surgery. Most patients with facial paralysis caused by a congenital defect, trauma, or a tumor underwent reanimation. There were no sex- or synkinesis-related differences in the doses used, but the doses were higher in the reanimation group than in the no-surgery group. Synkinesis was found in 196 patients; 148 (41.9 percent) presented with postparalysis synkinesis (oro-ocular, oculo-oral) and 58 (16.4 percent) presented with postreanimation

2015 Plastic and reconstructive surgery

46. Diabetic Mice Show an Aggravated Course of Herpes-Simplex Virus-Induced Facial Nerve Paralysis. (PubMed)

Diabetic Mice Show an Aggravated Course of Herpes-Simplex Virus-Induced Facial Nerve Paralysis. Bell's palsy is highly associated with diabetes mellitus.The cause of Bell's palsy in diabetes mellitus is not completely understood. Diabetic mononeuropathy or reactivation of herpes simplex virus type 1 (HSV-1) may be responsible for the facial paralysis seen in diabetic patients. We previously reported transient and ipsilateral facial paralysis in mice inoculated with HSV-1. In this study, we (...) increased in the diabetic mice. Electrophysiologic examinations and histopathologic changes also revealed that the facial nerve damage was more severe in the diabetic group.The aggravated course of HSV-1 infection in diabetes suggests that HSV-1 may be the main causative factor for the increased incidence of facial paralysis in diabetic patients.

2012 Otology and Neurotology

47. Modified Stennert’s Protocol in Treating Acute Peripheral Facial Nerve Paralysis: Our Experience (PubMed)

Modified Stennert’s Protocol in Treating Acute Peripheral Facial Nerve Paralysis: Our Experience The aim of this study was to know the effect of modified Stennert's protocol on Bell's palsy and delayed onset post traumatic facial nerve paralysis. Retrospective study method which included 26 patients was done. Of this 19 patients had Bell's palsy and seven patients had delayed onset post traumatic facial nerve paralysis. All patients started on modified Stennert's protocol. Nineteen patients (...) were observed and had idiopathic facial nerve paralysis. Fifteen patients showed clinical improvement by the 10th day and by the end of 1 month, 18 patients showed significant symptomatic improvement. One patient had residual defects at 6 months. Of the seven patients with delayed onset post traumatic facial nerve paralysis, three patients had to undergo facial nerve decompression, the remaining four receiving only modified Stennert's protocol. Improvement was seen in three patients by the 10th day

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2012 Indian Journal of Otolaryngology and Head & Neck Surgery

48. Hemihypoglossal nerve transfer for acute facial paralysis. (PubMed)

Hemihypoglossal nerve transfer for acute facial paralysis. The authors have developed a technique for the treatment of facial paralysis that utilizes anastomosis of the split hypoglossal and facial nerve. Here, they document improvements in the procedure and experimental evidence supporting the approach.They analyzed outcomes in 36 patients who underwent the procedure, all of whom had suffered from facial paralysis following the removal of large vestibular schwannomas. The average period (...) of paralysis was 6.2 months. The authors used 5 different variations of a procedure for selecting the split nerve, including evaluation of the split nerve using recordings of evoked potentials in the tongue.Successful facial reanimation was achieved in 16 of 17 patients using the cephalad side of the split hypoglossal nerve and in 15 of 15 patients using the caudal side. The single unsuccessful case using the cephalad side of the split nerve resulted from severe infection of the cheek. Procedures using

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2012 Journal of Neurosurgery

49. Static Suspension for Facial Paralysis

Suspension for Facial Paralysis Updated: Oct 26, 2018 Author: Suzanne K Doud Galli, MD, PhD; Chief Editor: Arlen D Meyers, MD, MBA Share Email Print Feedback Close Sections Sections Static Suspension for Facial Paralysis Overview Background The mimetic muscles direct facial movements. Under the control of the seventh cranial nerve (CN VII), the movement of these muscles correlates with the communication of human thought, emotion, and expression. Loss of this capacity is disfiguring and dysfunctional (...) include the extensor digitorum brevis, gracilis, latissimus dorsi, pectoralis minor, and serratus anterior. The advantage of free muscle transfer over regional muscle transfer has not been established. Previous Next: Etiology The various etiologies of facial paralysis can be classified into 3 major groups, ie, intracranial, intratemporal, and extracranial (see Relevant Anatomy). Regardless of the cause, the importance of establishing the degree and duration of weakness when evaluating a patient must

2014 eMedicine Surgery

50. Congenital Facial Paralysis

cases of facial paralysis. [ ] The incidence of facial paralysis in live births is 0.8-2.1 per 1000 births, and, of these, 88% are associated with a difficult labor. Of patients with birth trauma, 67-91% are associated with forceps delivery. [ , , ] Developmental causes include those associated with syndromes and teratogens. An example of a development cause is , which has an incidence of 1 per 50,000 births. [ ] A common disorder that resembles a unilateral partial nerve paralysis is congenital (...) unilateral lower lip palsy (CULLP), also known as neonatal asymmetric crying facies, that occurs in 1 out of 160 live births. [ ] The estimated prevalence of facioscapulohumeral muscular dystrophy (FSH MD) is between 1/20,000 and 1/8000, making it the world’s third-most-common inherited myopathy. [ ] Previous Next: Etiology The cause of congenital facial paralysis is associated with either a traumatic injury or developmental deformities of the brain or facial nerve (cranial nerve VII). [ ] Trauma

2014 eMedicine Surgery

51. Dynamic Reanimation for Facial Paralysis

> Dynamic Reanimation for Facial Paralysis Updated: Jan 09, 2019 Author: Steven M Parnes, MD; Chief Editor: Arlen D Meyers, MD, MBA Share Email Print Feedback Close Sections Sections Dynamic Reanimation for Facial Paralysis Overview Background Facial paralysis can be a consequence of traumatic facial nerve injury, iatrogenic causes, malignancy, congenital syndromes, and viral infections. Prolonged paralysis can result in ocular complications, articulation difficulties, impaired feeding, and difficulty (...) in conveying emotion through expressive movement. Numerous reanimation techniques are available to restore function and are based on the cause of the facial paralysis, type of injury, its location, and the anticipated duration. These methods are broadly classified into 4 types as follows: (1) neural methods, (2) musculofascial transpositions, (3) microneurovascular transfer (4) facial plastic procedures, and (5) prosthetics. The most desirable procedures to reestablish the mimetic control of the face

2014 eMedicine Surgery

52. Profile of facial palsy in Arar, northern Saudi Arabia (PubMed)

Profile of facial palsy in Arar, northern Saudi Arabia The term facial palsy generally refers to weakness of the facial muscles, mainly resulting from temporary or permanent damage to the facial nerve. Common causes of facial paralysis include infection or inflammation of the facial nerve, head trauma, head or neck tumor, stroke.To outline the incidence of several etiologies and the profile of patients with peripheral facial paralysis attending the outpatient clinic of the neurology department (...) in Hospitals of Arar City, Saudi Arabia.This cross-sectional study was carried out in Arar city from October 2016 to May 2017. The study was conducted in the outpatient clinic of the neurology department in hospitals of Arar City. Any ages of both sexes of all newly diagnosed unilateral facial palsy were included in the study. Data were analyzed by SPSS version 15, using descriptive statistics and Chi-square test. P-value was considered significant if <0.05.The mean age of the facial palsy cases was 33.65

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2017 Electronic physician

53. Facial Reanimation After Facial Nerve Injury Using Hypoglossal to Facial Nerve Anastomosis: The Gruppo Otologico Experience (PubMed)

patients completed a minimal follow up of 24 months at the time of evaluation and were included in the study population. Facial nerve paralysis was present for a mean duration of 11.3 months (range 2-42 months) and all the patients had a HB grade VI prior their surgery. Final facial nerve motor function. The most common cause of facial paralysis was vestibular Schwannoma surgery. All the patients achieved a postoperative HB grade III or IV after a mean follow-up time of 20 months. The facial movements (...) were detected after a period that ranged from ranged from 5 to 9 months. Only 4 patients suffered from difficulties during eating and drinking and three of them had associated lower cranial nerve deficit. Despite the various techniques in facial reanimation following total facial nerve paralysis, the end to end of hypoglossal to facial nerve anastomosis remains one of the best treatments in cases of viable distal facial stump and nonatrophic musculature.

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2012 Indian Journal of Otolaryngology and Head & Neck Surgery

54. CRACKCast 107 – Peripheral Nerve Disorders

= Central Nervous System + Peripheral Nervous System PNS divided into 12 cranial nerves (Remember episode 105?) 31 spinal nerves (8 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 1 coccygeal). Almost all of these nerves have Sensory, Motor and autonomic function Anatomically / functionally speaking the autonomic nervous system is divided into: Sympathetic (thoracolumbar) component Parasympathetic (craniosacral) component. Note: Autonomic dysfunction may cause systemic abnormalities (e.g., Orthostasis (...) Asymmetrical [2] List 8 causes of acute emergent weakness and possible respiratory compromise See box 97.1 in Rosen’s 9 th Edition for causes of acute, emergent weakness and possible respiratory compromise Autoimmune Demyelinating Guillain-Barré syndrome (GBS) Chronic inflammatory demyelinating polyneuropathy Myasthenia gravis Toxic Botulism Buckthorn Seafood Paralytic shellfish toxin Tetrodotoxin (puffer fish, newts) Tick paralysis Metals Arsenic Thallium Metabolic Dyskalemic syndromes Acquired

2017 CandiEM

55. CRACKCast E105 – Brain and Cranial Nerve Disorders

mononucleosis) disease if: Systemic symptoms Bilateral facial paresis Remember: caused by the spirochete Borrelia burgdorferi from Ixodes genus ticks [7] Differentiate between herpes zoster ophthalmicus and herpes zoster oticus Herpes zoster ophthalmicus = shingles of the trigeminal nerve Hutchinson’s sign: cutaneous involvement of nasociliary nerve Look for ocular involvement = punctate epithelial erosions and pseudodendrites Herpes zoster oticus = Ramsay Hunt syndrome Unilateral facial paralysis Can (...) = Carbamazapine 100mg PO BID. Other options: Phenytoin Baclofen Valproate sodium Lamotrigine Gabapentin Levetiracetam Disposition: Neurology with +/- Neurosurgery or ENT consult if surgical decompression is required [4] Facial nerve paralysis: List 6 differential diagnoses for facial (CN VII) paralysis Bell’s palsy Ramsey Hunt syndrome (herpes zoster oticus) Lyme disease (neuroborreliosis) Bacterial infections of the middle ear, mastoid, or external auditory canal Guillain-Barré syndrome HIV infection Tumor

2017 CandiEM

56. Polytetrafluoroethylene granuloma-associated facial palsy following microvascular decompression. (PubMed)

Polytetrafluoroethylene granuloma-associated facial palsy following microvascular decompression. Microvascular decompression (MVD) may be employed in the management of hemifacial spasm (HFS), wherein a pledget of polytetrafluoroethylene (i.e., Teflon, Chemours, Wilmington DE) is sometimes introduced to separate an offending vessel from the cisternal segment of facial nerve. Rarely, Teflon may cause a granulomatous reaction resulting in nerve palsy. We here present the first case series (...) of facial palsy thought to be secondary to Teflon granuloma following MVD for HFS.A data repository of 1,312 patients with facial palsy was reviewed to identify individuals who had previously undergone MVD for HFS. Data collected include age at time of MVD, age at onset of facial weakness and at presentation, House-Brackmann scores, clinician-graded facial function using the Electronic Facial Paralysis Assessment scale, imaging findings, and therapeutic interventions and outcomes.Six patients meeting

2019 Laryngoscope

57. Rehabilitation of Central Facial Paralysis With Hypoglossal-Facial Anastomosis. (PubMed)

Rehabilitation of Central Facial Paralysis With Hypoglossal-Facial Anastomosis. To evaluate the ability of hypoglossal-facial nerve anastomosis to reanimate the face in patients with complete nuclear (central) facial nerve palsy.Retrospective case series.Tertiary academic medical center.Four patients with complete facial nerve paralysis due to lesions of the facial nucleus in the pons caused by hemorrhage due to arteriovenous or cavernous venous malformations, stroke, or injury after tumor (...) /VI, and 25% had HB grade IV/VI. Average facial disability index scores were 61.25 for physical function and 78 for social/well-being, comparable to results from complete hypoglossal-facial anastomosis after peripheral facial nerve palsy after acoustic neuroma resection.Patients with nuclear facial paralysis who undergo end-to-end hypoglossal-facial nerve anastomosis achieve similar degrees of reanimation compared with those with peripheral facial nerve palsies. This raises the intriguing

2012 Otology and Neurotology

58. Small Vestibular Schwannomas Presenting with Facial Nerve Palsy. (PubMed)

Small Vestibular Schwannomas Presenting with Facial Nerve Palsy. To describe the surgical management and convalescence of two patients presenting with severe facial nerve weakness associated with small intracanalicular vestibular schwannomas (VS).Retrospective review.Two adult female patients presenting with audiovestibular symptoms and subacute facial nerve paralysis (House-Brackmann Grade IV and V). In both cases, post-contrast T1-weighted magnetic resonance imaging revealed an enhancing (...) cause severe facial neuropathy, mimicking the presentation of facial nerve schwannomas and other less common pathologies. In the absence of labyrinthine extension on MRI, surgical exploration is the only reliable means of establishing a diagnosis. In the case of confirmed VS, early gross total resection with facial nerve preservation and labyrinthine segment decompression may afford full motor recovery-an outcome that cannot be achieved with facial nerve grafting.

2014 Otology and Neurotology

59. Facial nerve palsy after reactivation of herpes simplex virus type 1 in diabetic mice. (PubMed)

Facial nerve palsy after reactivation of herpes simplex virus type 1 in diabetic mice. Bell's palsy is highly associated with diabetes mellitus (DM). Either the reactivation of herpes simplex virus type 1 (HSV-1) or diabetic mononeuropathy has been proposed to cause the facial paralysis observed in DM patients. However, distinguishing whether the facial palsy is caused by herpetic neuritis or diabetic mononeuropathy is difficult. We previously reported that facial paralysis was aggravated in DM (...) mice after HSV-1 inoculation of the murine auricle. In the current study, we induced HSV-1 reactivation by an auricular scratch following DM induction with streptozotocin (STZ).Controlled animal study.Diabetes mellitus was induced with streptozotocin injection in only mice that developed transient facial nerve paralysis with HSV-1. Recurrent facial palsy was induced after HSV-1 reactivation by auricular scratch.After DM induction, the number of cluster of differentiation 3 (CD3)(+) T cells

2014 Laryngoscope

60. Use of Objective Metrics in Dynamic Facial Reanimation: A Systematic Review. (PubMed)

Use of Objective Metrics in Dynamic Facial Reanimation: A Systematic Review. Facial nerve deficits cause significant functional and social consequences for those affected. Existing techniques for dynamic restoration of facial nerve function are imperfect and result in a wide variety of outcomes. Currently, there is no standard objective instrument for facial movement as it relates to restorative techniques.To determine what objective instruments of midface movement are used in outcome (...) measurements for patients treated with dynamic methods for facial paralysis.Database searches from January 1970 to June 2017 were performed in PubMed, Embase, Cochrane Library, Web of Science, and Scopus. Only English-language articles on studies performed in humans were considered. The search terms used were ("Surgical Flaps"[Mesh] OR "Nerve Transfer"[Mesh] OR "nerve graft" OR "nerve grafts") AND (face [mh] OR facial paralysis [mh]) AND (innervation [sh]) OR ("Face"[Mesh] OR facial paralysis [mh

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2018 JAMA facial plastic surgery

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