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Facial Nerve Paralysis Causes

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61. Facial Nerve Repair

: Tang Ho, MD, MSc; Chief Editor: Arlen D Meyers, MD, MBA Share Email Print Feedback Close Sections Sections Facial Nerve Repair Overview Background This article describes facial nerve repair for facial paralysis. Paralysis of the facial nerve is a cause of significant functional and aesthetic compromise. [ ] Functional concerns primarily involve adequate protection of the eye, with a real risk of exposure keratitis if not properly addressed. In addition, swallowing, drooling, and speech difficulties (...) of the facial nerve. Facial paralysis has many causes, which may be conveniently divided into the following 5 categories: Congenital Idiopathic Traumatic Neoplastic Inflammatory Congenital facial paralysis, as in the well-described although poorly understood Möbius syndrome, is uncommon. Idiopathic facial paralysis (Bell palsy) is the most common type. It is often thought to be due to virally induced inflammation of the nerve that results in functional compromise, swelling, and vascular compromise. Facial

2014 eMedicine Surgery

62. Facial Nerve, Intratemporal Bone Trauma

to these anatomic factors. can result in devastating social consequences for the patient. The seventh, ie, facial, nerve contains motor, sensory, and parasympathetic fibers. Among its functions are the vital control of facial expression, taste to the anterior two thirds of the tongue, and salivary-gland and lacrimal-gland secretion. More than 40 causes of facial paralysis are known. Trauma is a distant second to idiopathic or as a cause of facial nerve paralysis. In an overview of 1322 patients with facial (...) paralysis, May (1983) reported that 16% were caused by trauma. [ ] Although the facial nerve is susceptible to trauma along its entire length, the temporal bone is the most common site of trauma resulting in facial paralysis. The objective of this article is to review facial paralysis resulting from trauma to the intratemporal bone. Next: Epidemiology Frequency Approximately 5% of people who have trauma have temporal bone fractures. These fractures are traditionally classified with respect to the axis

2014 eMedicine Surgery

63. Facial Nerve Embryology

, accurate diagnosis is important if the etiology is traumatic. In rare cases, surgery and facial nerve repair may be required in the newborn if the etiology is determined to be traumatic. The evaluation of facial nerve paralysis includes the use of electromyograms (EMGs), evoked electromyograms (EEMGs), and computed tomography (CT) scans. If the etiology is traumatic, the nerve can be stimulated for 3-5 days postnatal; fibrillation potentials on EMG develop 14-21 days after birth. If the cause (...) Stapedius muscle Manubrium of malleus Long process incus Stapes (except for footplate) Facial canal Styloid process Stylohyoid ligament Lesser cornu of hyoid Upper body of hyoid Previous Next: Congenital Facial Paralysis Abnormalities of the facial nerve may occur in conjunction with malformations of the ear, in isolation without associated anomalies, or in conjunction with a variety of syndromes that include abnormalities elsewhere in the body. In the newborn, the otolaryngologist evaluating a facial

2014 eMedicine Surgery

64. Facial Nerve Anatomy

is thought to be due to basal nuclei disease. Lower midbrain A lesion in the lower midbrain above the level of the facial nucleus may cause contralateral paresis of the face and muscles of the extremities, ipsilateral abducens muscle paresis (due to effects on the abducens nerve), and ipsilateral internal strabismus. If the lesion extends far enough laterally to include the emerging facial nerve fibers, a peripheral type of ipsilateral facial paralysis may be apparent. Pons The facial motor nucleus (...) is located in the lower third of the pons, beneath the fourth ventricle. The neurons leaving the nucleus pass around the abducens nucleus as they emerge from the brainstem. Involvement of the facial nerve nucleus and VI nerve nucleus are suggestive of a lesion near the fourth ventricle. A lesion near the ventricle at the level of the superior salivatory nucleus may result in a dry eye in addition to a peripheral facial paralysis and abducens paresis. Many syndromes are known to result from pontine

2014 eMedicine Surgery

65. Monitors, Facial Nerve

be expected during a given operative procedure depends on the following variables: The adequacy of intramuscular electrode placement The number of independent electromyographic channels The effectiveness of nerve stimulation The level of nerve irritability The conduction status of the nerve distal to the point of stimulation Silverstein pointed out that a conduction block in the distal portion of the nerve causes a loss in the monitoring value of the facial nerve monitor proximal to that point. [ ] Prass (...) of whether both the orbicularis oris and the orbicularis oculi channels are activated with intraoperative stimulation. Identification of injury risk The monitor can be used to determine that certain types of surgical manipulations are potentially injurious to the nerve. Tugging, torsion of the nerve, or scraping tumor from the nerve may result in facial nerve stimulations, which, in turn, can indicate to the surgeon that he or she is at risk of causing facial nerve injury. The surgeon can then adjust his

2014 eMedicine Surgery

66. Treatment of Ramsay-Hunt's syndrome with multiple cranial nerve involvement and severe dysphagia: A case report. Full Text available with Trip Pro

Treatment of Ramsay-Hunt's syndrome with multiple cranial nerve involvement and severe dysphagia: A case report. Ramsay-Hunt's syndrome (RHS) is a disorder characterized by facial paralysis, herpetic eruptions on the auricle, and otic pain due to the reactivation of latent varicella zoster virus in the geniculate ganglion. A few cases of multiple cranial nerve invasion including the vestibulocochlear nerve, glossopharyngeal nerve and vagus nerve have been reported. However, there has been (...) no report about RHS with delayed onset multiple cranial nerve involvement causing severe aspiration, and a clinical course that improved after more than one year of dysphagia rehabilitation and percutaneous endoscopic gastrostomy (PEG). Here, we report on a 67-year old male with delayed onset swallowing difficulty after 16 days of RHS development.Severe aspiration during swallowing.Severe dysphagia caused by RHS with multiple cranial nerve involvement.Application of percutaneous endoscopic gastrostomy

2018 Medicine

67. Role of nitric oxide in the onset of facial nerve palsy by HSV-1 infection. Full Text available with Trip Pro

Role of nitric oxide in the onset of facial nerve palsy by HSV-1 infection. Although herpes simplex virus type 1 (HSV-1) is a causative agent of Bell palsy, the precise mechanism of the paralysis remains unknown. It is necessary to investigate the pathogenesis and treatment of Bell palsy due to HSV-1 infection.This study elucidated the role of nitric oxide (NO) in the incidence of facial nerve paralysis caused by HSV-1 in mice and to evaluate the possible role of edaravone, a free radical (...) , the incidence of facial palsy decreased significantly.These findings suggest that NO produced by inducible NO synthase in the facial nerve plays an important role in the onset of facial palsy caused by HSV-1 infection, which is considered a causative virus of Bell palsy. Hato and colleagues elucidate the role of nitric oxide in HSV-1–related facial nerve paralysis in mice and evaluate the role of edaravone, a free radical scavenger, in preventing the paralysis.

2013 JAMA otolaryngology-- head & neck surgery

68. Stapedial Synkinesis Causing Change in Hearing Threshold With Facial Motion. (Abstract)

pure-tone changes in hearing threshold with activation of the facial musculature.A single patient is presented who developed stapedial synkinesis after suboccipital resection of a unilateral acoustic neuroma.Despite facial nerve sparing, surgery resulted in House-Brackmann grade V/VI right facial nerve paralysis that improved to Grade III/VI after 7 months. Synkinesis developed that caused eye closure with puckering of the lips. Puckering of the lips likewise caused decreased hearing in the right (...) Stapedial Synkinesis Causing Change in Hearing Threshold With Facial Motion. Synkinetic facial movement after facial nerve regeneration is a well-documented phenomenon. Rarely, patients recovering from facial nerve injury report feelings of auditory ringing, fullness, and a sensation of ear tightness as a result of stapedial muscle involvement. It is exceedingly rare for such synkinesis to produce perceivable changes in hearing threshold. We report a unique case of stapedial synkinesis causing

2013 Otology and Neurotology

69. RYR1 mutations as a cause of ophthalmoplegia, facial weakness, and malignant hyperthermia. Full Text available with Trip Pro

RYR1 mutations as a cause of ophthalmoplegia, facial weakness, and malignant hyperthermia. Total ophthalmoplegia can result from ryanodine receptor 1 (RYR1) mutations without overt associated skeletal myopathy. Patients carrying RYR1 mutations are at high risk of developing malignant hyperthermia. Ophthalmologists should be familiar with these important clinical associations.To determine the genetic cause of congenital ptosis, ophthalmoplegia, facial paralysis, and mild hypotonia segregating (...) causative mutations in affected family members. Histories, physical examinations, and clinical data were reviewed.Mutations in RYR1.Missense mutations resulting in 2 homozygous RYR1 amino acid substitutions (E989G and R3772W) and 2 compound heterozygous RYR1 substitutions (H283R and R3772W) were identified in a consanguineous and a nonconsanguineous pedigree, respectively. Orbital magnetic resonance imaging revealed marked hypoplasia of extraocular muscles and intraorbital cranial nerves. Skeletal

2013 JAMA ophthalmology

70. Bilateral Facial Nerve Palsy: A Diagnostic Dilemma Full Text available with Trip Pro

Bilateral Facial Nerve Palsy: A Diagnostic Dilemma Introduction. Bilateral facial nerve palsy (FNP) is a rare condition, representing less than 2% of all cases of FNP. Majority of these patients have underlying medical conditions, ranging from neurologic, infectious, neoplastic, traumatic, or metabolic disorders. Objective. The differential diagnosis of its causes is extensive and hence can present as a diagnostic challenge. Emergency physicians should be aware of these various diagnostic (...) possibilities, some of which are potentially fatal. Case Report. We report a case of a 43-year-old female who presented to the emergency department with sequential bilateral facial nerve paralysis which could not be attributed to any particular etiology and, hence, presented a diagnostic dilemma. Conclusion. We reinforce the importance of considering the range of differential diagnosis in all cases presenting with bilateral FNP. These patients warrant admission and prompt laboratory and radiological

2012 Case Reports in Emergency Medicine

71. Evidence-based Guideline: Vagus nerve stimulation for the treatment of epilepsy

explanted, and one was reimplanted later in the study (time frame unspecified). Left vocal cord paralysis occurred in 2, lower facial muscle paresis occurred in 2, and fluid accumulation over the gen- erator requiring aspiration occurred in one. The fre- quency of other AEs was “dose”-related; that is, greater at the highest-tolerated stimulation intensity vs the lowest-perceptible stimulation intensity: voice alteration 47.4% vs 9.7%, dyspnea 11.6% vs 1.0%, pharyngitis 15.8% vs 3.9%. Two additional (...) Evidence-based Guideline: Vagus nerve stimulation for the treatment of epilepsy DOI 10.1212/WNL.0b013e3182a393d1 2013;81;1453-1459 Published Online before print August 28, 2013 Neurology George L. Morris III, David Gloss, Jeffrey Buchhalter, et al. Subcommittee of the American Academy of Neurology treatment of epilepsy: Report of the Guideline Development Evidence-based guideline update: Vagus nerve stimulation for the This information is current as of August 28, 2013 http://www.neurology.org

2013 American Epilepsy Society

72. Vagus nerve stimulation for the treatment of epilepsy

patient died from unrelated causes. The clinical trial leading to FDA approval of the VNS device was used for comparison. e16 It included 254 adult patients with refractory partial epilepsy (mean age 32 years, range 13–60 years). Surgical infectious complications occurred in 3 patients; all were explanted, and one was reimplanted later in the study (time frame unspecified). Left vocal cord paralysis occurred in 2, lower facial muscle paresis occurred in 2, and fluid accumulation over the generator (...) Vagus nerve stimulation for the treatment of epilepsy Evidence-based guideline update: Vagus nerve stimulation for the treatment of epilepsy | Neurology Advertisement Search for this keyword Main menu User menu Search Search for this keyword The most widely read and highly cited peer-reviewed neurology journal Share October 15, 2013 ; 81 (16) Special Article Evidence-based guideline update: Vagus nerve stimulation for the treatment of epilepsy Report of the Guideline Development Subcommittee

2013 American Academy of Neurology

73. Goitre causes, investigation and management

thyroid conditions should seek advice from their medical practitioner before commencing a supplement. Clinical presentation nodular goitre is most often detected simply as a mass in the neck, but an enlarging gland may also produce pressure symptoms on the trachea and the oesophagus. As well as discomfort, there may be difficulty in breathing, dysphagia, cough and hoarseness. Paralysis of the recurrent laryngeal nerve may occur when the nerve Table 1. Common causes of goitre • Hashimoto thyroiditis (...) Goitre causes, investigation and management Thyroid 572 Reprinted from AustRAliAn F Amily PhysiciAn Vol. 41, no. 8, August 2012 Kiernan Hughes Creswell Eastman Goitre Causes, investigation and management Background Goitre refers to an enlarged thyroid. Common causes of goitre include autoimmune disease, thyroid nodules and iodine deficiency. Objective This article outlines the causes, investigation and management of goitre in the Australian general practice setting. Discussion Patients

2012 Clinical Practice Guidelines Portal

74. Cranial Nerve 7

, Cranial Nerve VII , Facial Nerve , CN 7 , Geniculate Ganglion , Superior Salivatory Nucleus , Superior Salivary Nucleus II. Causes: Paralysis Neoplasm (Infectious polyneuritis) Melkersson's Syndrome (Recurrent ) Poliomyelitis (ALS) III. Anatomy: Course to Geniculate Ganglion ral Facial Nerve originates in four nucleii in pons and All combine to travel via internal auditory meatus into Geniculate Ganglion Each side of the forehead is innervated by both s (but only one peripheral Facial Nerve) Forehead (...) IS involved with a peripheral Facial Nerve lesion (LMN) such as in Forehead IS NOT involved with an UMN deficit from a central lesion such as a CVA Most important of the four components Innervates muscles of facial expression (and stapedius) Originates in pons at facial nucleus (in the somatovisceral region) First courses medially within the pons (paradoxical) Circles clockwise around 6th Passes anterior to the Then exits the pons Innervates lacrimal glands (via pterygopalatine ) Innervates submaxillary

2018 FP Notebook

75. Facial Palsy, a Disorder Belonging to Influential Neurological Dynasty: Review of Literature Full Text available with Trip Pro

Facial Palsy, a Disorder Belonging to Influential Neurological Dynasty: Review of Literature Facial paralysis is one of the common problem leading to facial deformation. Bell's palsy (BP) is defined as a lower motor neuron palsy of acute onset and idiopathic origin. BP is regarded as a benign common neurological disorder of unknown cause. It has an acute onset and is almost always a mononeuritis. The facial nerve is a mixed cranial nerve with a predominant motor component, which supplies all (...) muscles concerned with unilateral facial expression. Knowledge of its course is vital for anatomic localization and clinical correlation. BP accounts for approximately 72% of facial palsies. Almost a century later, the management and etiology of BP is still a subject of controversy. Here, we present a review of literature on this neurologically significant entity.

2016 North American journal of medical sciences

76. Facial nerve palsy caused by parotid gland abscess. (Abstract)

Facial nerve palsy caused by parotid gland abscess. We present the first report of methicillin-resistant Staphylococcus aureus and Propionibacterium acnes parotid abscesses complicated by facial nerve palsy. Facial nerve palsy secondary to parotid gland abscess is rare, with only eight previously reported cases.Case reports and literature review concerning parotid abscess and facial nerve palsy presentation and management.Within two months, two female patients presented with parotid gland (...) abscess complicated by unilateral facial paralysis. Both were treated with intravenous antibiotics and surgery. In the first case, methicillin-resistant Staphylococcus aureus was cultivated, in the other, Propionibacterium acnes was found. In the first case, facial nerve function did not recover.Parotid gland abscess can lead to facial paralysis. Both methicillin-resistant Staphylococcus aureus and Propionibacterium acnes may be involved. Ultrasonography or computed tomography is recommended

2011 Journal of Laryngology & Otology

77. Infrared-Based Blink-Detecting Glasses for Facial Pacing: Toward a Bionic Blink. Full Text available with Trip Pro

Infrared-Based Blink-Detecting Glasses for Facial Pacing: Toward a Bionic Blink. IMPORTANCE Facial paralysis remains one of the most challenging conditions to effectively manage, often causing life-altering deficits in both function and appearance. Facial rehabilitation via pacing and robotic technology has great yet unmet potential. A critical first step toward reanimating symmetrical facial movement in cases of unilateral paralysis is the detection of healthy movement to use as a trigger (...) for stimulated movement. OBJECTIVE To test a blink detection system that can be attached to standard eyeglasses and used as part of a closed-loop facial pacing system. DESIGN, SETTING, AND PARTICIPANTS Standard safety glasses were equipped with an infrared (IR) emitter-detector unit, oriented horizontally across the palpebral fissure, creating a monitored IR beam that became interrupted when the eyelids closed, and were tested in 24 healthy volunteers from a tertiary care facial nerve center community. MAIN

2014 JAMA facial plastic surgery

78. Facial Nerve Palsy

the geniculate ganglion or along the entire course of the nerve. However, its enhancement may reflect other causes, such as meningeal tumor. If the paralysis progresses over weeks to months, the likelihood of a tumor (eg, most commonly schwannoma) compressing the facial nerve increases. MRI can also help exclude other structural disorders causing facial nerve palsy. CT, usually negative in Bell palsy, is done if a fracture is suspected or if MRI is not immediately available and stroke is possible (...) , serum ACE level) are done to diagnose treatable causes. Treatment may include lubrication of the eye, intermittent use of an eye patch, and, for idiopathic facial nerve palsy, corticosteroids. (See also .) Etiology Historically, Bell palsy was thought to be idiopathic facial nerve (peripheral 7th cranial nerve) palsy. However, facial nerve palsy is now considered a clinical syndrome with its own differential diagnosis, and the term "Bell palsy" is not always considered synonymous with idiopathic

2013 Merck Manual (19th Edition)

79. Endoscopic Management of Facial Fractures

and avoidance of electrocautery reduces this risk. Facial nerve paralysis is possible but highly unlikely because the entire dissection is performed in a subperiosteal plane. Whenever alloplastic implants are used, implant infection or extrusion is a risk. However, porous polyethylene has been used extensively in the maxillofacial skeleton with good clinical results. Also, while a potential for delayed fragmentation of HA cements exists, this has thus far not been reported for this type of reconstruction (...) table fractures are primarily an aesthetic problem. They do not involve the posterior table and are therefore felt to carry a low risk of long-term complications. Traditional open reduction of isolated anterior table fractures requires a coronal incision for adequate exposure and fracture repair. Success rates are very high, but the procedure produces surgical stigmata, including a large scar, possible alopecia, paresthesias, and even facial nerve injury (temporal branch). The endoscopic approach

2014 eMedicine Surgery

80. Experience with developmental facial paralysis: Part I. Diagnosis and associated stigmata. (Abstract)

Experience with developmental facial paralysis: Part I. Diagnosis and associated stigmata. This study is a thorough literature review of the clinical presentation and evaluation of developmental facial paralysis, with a systematic description of the various stigmata and associated anomalies. It is hoped that this approach will facilitate the differentiation of developmental facial paralysis from other causes of facial paralysis present at birth.Forty-two cases of developmental facial paralysis (...) the presence of developmental facial paralysis and amblyopia, hypoplastic facial nerve on imaging or surgical exploration, lower alar atresia, and skin changes (i.e., acne), but not the ear abnormalities.Early targeted screening and diagnosis, with prompt specialized treatment, improves the physical and emotional development of children with developmental facial paralysis and reduces the prevalence of amblyopia and other sequelae of the condition, thus facilitating reintegration among their peers. Given

2011 Plastic and reconstructive surgery

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