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Facial Nerve Paralysis Causes

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81. 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)

82. 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

83. 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

84. Reinnervation of Facial Muscles After Lengthening Temporalis Myoplasty

Pathology cause of facial paralysis evolving Pregnant or lactating Patient incapacitated adult Patient undergoing another study at the same time Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01833221 Locations Layout table for location information (...) : University Hospital, Caen Information provided by (Responsible Party): University Hospital, Caen Study Details Study Description Go to Brief Summary: The purpose of this study is to determine the physiology of nerve healing and the neurotization of the facial muscles after lengthening temporalis myoplasty. Condition or disease Intervention/treatment Phase Facial Paresis Drug: injection of 1% lidocaine, 2mL for facial nerve block Phase 4 Detailed Description: The investigators want to study the physiology

2013 Clinical Trials

85. MKSAP: 53-year-old man with right-sided facial weakness

isolated facial nerve paralysis, immediate brain imaging is unnecessary. Most of these patients have idiopathic Bell palsy, and 70% to 90% achieve complete recovery within 3 months. Severe residual weakness occurs in a minority of patients with Bell palsy, but the persistence of significant deficits at 3 months should prompt further investigation, including evaluation for alternative causes of facial nerve paralysis (such as diabetes mellitus, Lyme disease, vasculitis, HIV infection, sarcoidosis (...) is inconsistent. Evidence supporting the benefit of physical therapy for rehabilitation after facial nerve palsy is insufficient. In this patient, a structural cause of the deficits should first be excluded. Key Point MRI of the brain is an appropriate next step in management for patients with incomplete recovery 3 months after onset of facial nerve palsy despite appropriate initial treatment. This content is excerpted from with permission from the (ACP). Use is restricted in the same manner as that defined

2016 KevinMD blog

86. Trochlear Nerve Palsy (Diagnosis)

. Curr Opin Ophthalmol . 2008 Sep. 19(5):379-83. . Dosunmu EO, Hatt SR, Leske DA, Hodge DO, Holmes JM. Incidence and Etiology of Presumed Fourth Cranial Nerve Palsy: A Population-based Study. Am J Ophthalmol . 2018 Jan. 185:110-114. . 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 Ophthalmol . 1992 May 15. 113(5):489-96. . Holmes JM, Mutyala S, Maus TL, et al. Pediatric third, fourth, and sixth (...) . Fourth nerve palsy: historical review and study of 215 inpatients. Neurology . 1993 Dec. 43(12):2439-43. . Robb RM. Idiopathic superior oblique palsies in children. J Pediatr Ophthalmol Strabismus . 1990 Mar-Apr. 27(2):66-9. . Rush JA, Younge BR. Paralysis of cranial nerves III, IV, and VI. Cause and prognosis in 1,000 cases. Arch Ophthalmol . 1981 Jan. 99(1):76-9. . Son S, Park CW, Yoo CJ, Kim EY, Kim JM. Isolated, contralateral trochlear nerve palsy associated with a ruptured right posterior

2014 eMedicine.com

87. Trochlear Nerve Palsy (Overview)

. Curr Opin Ophthalmol . 2008 Sep. 19(5):379-83. . Dosunmu EO, Hatt SR, Leske DA, Hodge DO, Holmes JM. Incidence and Etiology of Presumed Fourth Cranial Nerve Palsy: A Population-based Study. Am J Ophthalmol . 2018 Jan. 185:110-114. . 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 Ophthalmol . 1992 May 15. 113(5):489-96. . Holmes JM, Mutyala S, Maus TL, et al. Pediatric third, fourth, and sixth (...) . Fourth nerve palsy: historical review and study of 215 inpatients. Neurology . 1993 Dec. 43(12):2439-43. . Robb RM. Idiopathic superior oblique palsies in children. J Pediatr Ophthalmol Strabismus . 1990 Mar-Apr. 27(2):66-9. . Rush JA, Younge BR. Paralysis of cranial nerves III, IV, and VI. Cause and prognosis in 1,000 cases. Arch Ophthalmol . 1981 Jan. 99(1):76-9. . Son S, Park CW, Yoo CJ, Kim EY, Kim JM. Isolated, contralateral trochlear nerve palsy associated with a ruptured right posterior

2014 eMedicine.com

88. Schwannoma, Cranial Nerve

in 12 patients as facial nerve weakness or paralysis and in 8 patients as involuntary movements of the facial musculature. [ ] Trigeminal schwannomas can arise in the Meckel cave or in the cistern along the course of the nerve. [ ] Extension and expansion of the foramen rotundum or ovale is common, and the masses can have a bilobed appearance. Tumors can also grow posteriorly to involve the posterior fossa, or they can grow anteriorly into the cavernous sinus. Trigeminal schwannomas tend to have (...) of a cystic hypoglossal schwannoma causing unilateral tongue atrophy. Br J Neurosurg . 2013 Jul 15. . Chung SY, Kim DI, Lee BH, et al. Facial nerve schwannomas: CT and MR findings. Yonsei Med J . 1998 Apr. 39(2):148-53. . Behuria S, Rout TK, Pattanayak S. Diagnosis and management of schwannomas originating from the cervical vagus nerve. Ann R Coll Surg Engl . 2015 Mar. 97 (2):92-7. . Bittencourt AG, Alves RD, Ikari LS, Burke PR, Gebrim EM, Bento RF. Intracochlear schwannoma: diagnosis and management. Int

2014 eMedicine Radiology

89. Vertebral artery pexy for microvascular decompression of the facial nerve in the treatment of hemifacial spasm. (Abstract)

Vertebral artery pexy for microvascular decompression of the facial nerve in the treatment of hemifacial spasm. Hemifacial spasm (HFS) is caused by arterial or venous compression of cranial nerve VII at its root exit zone. Traditionally, microvascular decompression of the facial nerve has been an effective treatment for posterior inferior and anterior inferior cerebellar artery as well as venous compression. The traditional technique involves Teflon felt or another construct to cushion (...) ). All 6 patients had complete resolution of their HFS. Facial function was tested postoperatively, and was stable when compared with the preoperative baseline. Two of the 3 patients with preoperative tinnitus had resolution of this symptom after the procedure. Postoperative imaging demonstrated VA decompression of the facial nerve and no evidence of stroke in all patients. One patient suffered from hearing loss, another developed a postoperative transient unilateral vocal cord paralysis, and a third

2011 Journal of Neurosurgery

90. Dermoid cyst in the facial nerve--A unique diagnosis. (Abstract)

Dermoid cyst in the facial nerve--A unique diagnosis. Facial nerve paralysis in children may occur as a complication of infections, trauma, or rarely from benign or malignant tumors of the facial nerve. We present the first reported case of a dermoid tumor in the facial nerve causing facial paralysis in a child. Case report at a tertiary Children's Hospital. A 9-month-old was referred to our institution for evaluation of persistent, complete right sided facial paralysis three months after (...) was cable grafted. Histological examination of the tumor confirmed a ruptured dermoid cyst in the facial nerve. Facial nerve tumors are rare causes of facial paralysis in children, accounting for fewer than 10% of cases of facial paralysis in the pediatric population. Dermoid cyst can occur throughout the head and neck region in children, but a dermoid tumor in the facial nerve has not been described in the literature prior to this report. This represents a new and uncommon diagnostic entity

2011 International Journal of Pediatric Otorhinolaryngology

91. Use of Computed Tomography to Predict the Possibility of Exposure of the First Genu of the Facial Nerve Via the Transmastoid Approach. (Abstract)

the tympanic and labyrinthine segments. The other group included patients with facial paralysis who required facial nerve exploration, especially distal to the geniculate ganglion. Facial nerve decompression was performed in all patients as far proximal in the transmastoid view as was possible without causing damage to the semicircular canals.We correlated the temporal bone CT images and surgical findings in 11 patients who underwent facial nerve decompression via the transmastoid approach. The facial (...) Use of Computed Tomography to Predict the Possibility of Exposure of the First Genu of the Facial Nerve Via the Transmastoid Approach. The purpose of this study was to investigate whether computed tomography (CT) could predict the possibility of first genu exposure of the facial nerve via the transmastoid approach in patients with acute facial paralysis.Temporal bone CT is the best method for visualizing the intratemporal segment of the facial nerve canal, which is known to have diverse

2011 Otology and Neurotology

92. 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

2015 FP Notebook

93. A novel syndrome caused by the E410K amino acid substitution in the neuronal β-tubulin isotype 3. Full Text available with Trip Pro

does indeed segregate with the mutation, and expand the TUBB3 E410K phenotype to include Kallmann syndrome (hypogonadotropic hypogonadism and anosmia), stereotyped midface hypoplasia, intellectual disabilities and, in some cases, vocal cord paralysis, tracheomalacia and cyclic vomiting. Neuroimaging reveals a thin corpus callosum and anterior commissure, and hypoplastic to absent olfactory sulci, olfactory bulbs and oculomotor and facial nerves, which support underlying abnormalities in axon (...) A novel syndrome caused by the E410K amino acid substitution in the neuronal β-tubulin isotype 3. Missense mutations in TUBB3, the gene that encodes the neuronal-specific protein β-tubulin isotype 3, can cause isolated or syndromic congenital fibrosis of the extraocular muscles, a form of complex congenital strabismus characterized by cranial nerve misguidance. One of the eight TUBB3 mutations reported to cause congenital fibrosis of the extraocular muscles, c.1228G>A results in a TUBB3 E410K

2013 Brain

94. Overview of Neuro-ophthalmologic and Cranial Nerve Disorders

disease (eg, amyotrophic lateral sclerosis) *Disorders that cause diffuse motor paralysis (eg, myasthenia gravis, botulism, variant Guillain-Barré syndrome, poliomyelitis with bulbar involvement) often affect cranial nerves. Amyotrophic lateral sclerosis may cause prominent tongue fasciculations. Causes and symptoms of neuro-ophthalmologic and cranial nerve disorders overlap. Both types of disorders can result from tumors, inflammation, trauma, systemic disorders, and degenerative or other processes (...) , causing such symptoms as vision loss, diplopia, ptosis, pupillary abnormalities, periocular pain, facial pain, or headache. Diagnosis Evaluation of neuro-ophthalmologic and cranial nerve disorders includes the following: Detailed questioning about symptoms Tests to detect nystagmus (see ) Visual system examination includes ophthalmoscopy and testing of visual acuity, visual fields (see Table: ), pupils (see Table: ), and eye movements (ocular motility—see Table: ). As part of this testing, the 2nd

2013 Merck Manual (19th Edition)

95. Delayed facial nerve paresis after using the KTP laser in the treatment of cholesteatoma despite inter-operative facial nerve monitoring. (Abstract)

nerve injury was identified. Intra-operatively, the facial nerve was not encountered or exposed, and the KTP laser was not used directly on the nerve. The facial nerve monitor did not alarm. The three patients began experiencing a paresis from POD #7-9, with House-Brackmann facial nerve score of II-III at maximum severity. This resolved fully between 4 and 7 weeks after the onset of the paralysis. The KTP laser during cholesteatoma surgery has been shown to decrease residual disease but may however (...) also cause a temporary, delayed, mild facial nerve paresis. We discuss the mechanisms for injury and the role of intra-operative facial nerve monitoring in the context of this uncommon and unforeseen complication.Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

2010 International Journal of Pediatric Otorhinolaryngology

96. What Really Decides the Facial Function of Vestibular Schwannoma Surgery? Full Text available with Trip Pro

What Really Decides the Facial Function of Vestibular Schwannoma Surgery? To find the main cause of facial nerve dysfunction in vestibular schwannoma (VS) surgery and review the prognosis of facial function in relation to tumor size, preoperative facial function and surgical approach.We reviewed the surgical outcome of 134 patients with VS treated in our department between 1994 and 2008. All patients included in the study had postoperative facial paralysis after surgical management of their VS (...) . There were 14 women and 7 men. The mean age was 48.5 years, with a mean follow-up period of 57 months.Twenty-one patients (sustained facial palsy, 4; newly developed facial palsy, 17) had facial nerve paralysis after surgery: ten patients in large VS and eleven patients in small VS. In large VS group, 4 patients had facial nerve function of HB grade II, 3 patients had HB grade III, and 3 patients had HB grade IV. In small VS group, 9 patients had HB grade II and 2 patients had HB grade IV. Middle cranial

2011 Clinical and experimental otorhinolaryngology

97. Suspected neurological conditions: recognition and referral

and referral (NG127) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 11 of 731.6 Headaches in adults For advice on referral for headaches in adults, see the NICE guideline on headaches in over 12s. 1.7 Limb or facial weakness in adults Sudden-onset limb weakness Sudden-onset limb weakness 1.7.1 Be aware that sudden-onset weakness, even in restricted distribution (for example, sudden hand weakness), may be caused (...) claudication symptoms in adults with adequate peripheral circulation might be caused by lumbar canal stenosis and need specialist assessment and imaging. Recurrent limb or facial weakness as part of a functional neurological disorder Recurrent limb or facial weakness as part of a functional neurological disorder 1.7.7 Be aware that, for adults who have been diagnosed with a functional neurological disorder by a specialist, recurrent limb weakness might be part of the disorder and the person might not need

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

98. Central facial palsy

. To examine facial muscle movement often, (TMS) is used. Upper motoneuron lesions to the face often cause paralysis. The lesions cause weakness in various areas of the face while not affecting other areas of the face. This pattern of weakness due to the input of the motor neurons of the lower facial muscles is often maintained contralateral. The strength of the muscles in the upper region of the face are preserved better than the muscles in the lower face. It was found that in many anatomical studies (...) . from both sides of the brain) while the ventral division receives only input (i.e. from the opposite side of the brain). Thus, lesions of the between the and and the facial motor nucleus destroy or reduce input to the ventral division, but input (i.e. from the same side) to the dorsal division is retained. As a result, central facial palsy is characterized by hemiparalysis or of the contralateral , but not the muscles of the . Contents Signs and symptoms [ ] Central facial palsy is the paralysis

2012 Wikipedia

99. Otitis media (acute): antimicrobial prescribing

to hospital if they have acute otitis media associated with: a severe systemic infection (see the NICE guideline on sepsis) acute complications, including mastoiditis, meningitis, intracranial abscess, sinus thrombosis or facial nerve paralysis. See the evidence and committee discussion on choice of antibiotic. 1.2 Self-care All children and y All children and young people with acute otitis media oung people with acute otitis media 1.2.1 Offer regular doses of paracetamol or ibuprofen for pain, using (...) of infection, hearing loss (which is usually temporary) and perforated eardrum. However, antibiotics make little difference to the rates of these (see efficacy of antibiotics). Acute complications of acute otitis media (such as mastoiditis, meningitis, intracranial abscess, sinus thrombosis and facial nerve paralysis) are rare. The incidence of mastoiditis after otitis media is 1.8 per 10,000 episodes after antibiotics compared with 3.8 per 10,000 episodes without antibiotics. This gives a NNT of 4,831

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

100. Ménière’s Disease (Meniere) Full Text available with Trip Pro

, culminating in episodic ear symptoms, including vertigo, fluctuating hearing loss, tinnitus, and aural fullness. Schuknecht and Gulya postulated the theory of Reissner’s membrane rupture secondary to endolymphatic duct distention. These microtears would allow potassium-rich endolymph to bathe cochlear hair cells and the eighth cranial nerve. As such, repeated exposure to toxic levels of potassium-rich perilymph could cause episodic spinning vertigo as well as long-term decline in auditory function (...) (ie, prior ear surgery, otorrhea/chronic ear infections, otalgia, or prior hearing loss, either sensorineural or conductive) should be addressed at the time of evaluating a patient with suspected MD, including medical/surgical history (ie, allergies, neurologic history, ongoing headaches or facial numbness that may have been consistent with CPA tumors to include, but not be limited to, vestibular schwannomas; note that strokes, tumors, and other neurologic problems that cause dizziness may

2020 American Academy of Otolaryngology - Head and Neck Surgery

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