Facial nerve paralysis: Difference between revisions

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'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
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  | Caption        = Moche. Culture Representation of Facial Paralysis. 300 A.D. Larco Museum Collection, Lima, Peru.
  | Caption        = Moche. Culture Representation of Facial Paralysis. 300 A.D. Larco Museum Collection, Lima, Peru.
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{{CMG}}
{{Facial nerve paralysis}}
{{Facial nerve paralysis}}
{{CMG}}; {{GCC}}
==Overview==
'''Facial nerve paralysis''' and [[Bell's Palsy|Bell's palsy]] is due to a loss of voluntary movement of the muscles on one side of the face due to abnormal function of the facial nerve(s). A Peripheral palsy affects all ipsilateral muscles of facial expression (paralysis results on the entire ipsilateral side). A supranuclear palsy involves the lower part of the face.
'''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.
==[[Facial nerve paralysis overview|Overview]]==


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 [[eyebrow]]s. 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.
==[[Facial nerve paralysis historical perspective|Historical Perspective]]==


Laboratory investigations include an [[audiogram]], [[nerve conduction study|nerve conduction studies]] ([[Electroneuronography|ENoG]]), [[computed tomography]] (CT) or [[MRI|magnetic resonance]] (MR) imaging.
==[[Facial nerve paralysis classification|Classification]]==


== Laboratory Findings ==  
==[[Facial nerve paralysis pathophysiology|Pathophysiology]]==


==[[Facial nerve paralysis causes|Causes]]==


=== MRI and CT ===
==[[Facial nerve paralysis differential diagnosis|Differentiating Facial nerve paralysis from other Diseases]]==
* [[MRI]] and [[CT scan]] for supranuclear palsy


== Treatment ==
==[[Facial nerve paralysis epidemiology and demographics|Epidemiology and Demographics]]==
* Massage of weakened muscles, tape eye and use eye shield during sleep and possible electrical stimulation of paralyzed muscles ([[Bell's Palsy|Bell's palsy]])
* Treat underlying disease etiologies
* Consider neurologic referral


== Pharmacotherapy ==
==[[Facial nerve paralysis risk factors|Risk Factors]]==
* Corticosteroids and IV acyclovir for [[Bell's Palsy|Bell's palsy]]


== References ==
==[[Facial nerve paralysis natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
{{reflist|2}}


==Additional Resources==
==Diagnosis==
* [http://www.med.uwo.ca/UME/Diane/Year2Postings2004-2005/Trimester%202/CNS/AcuteFacialParalysisPowerpointDrParnes.ppt Acute facial nerve paralysis] - Powerpoint slides from a lecture presented to second year medical school students at the [http://www.uwo.ca/ University of Western Ontario] by Dr. Lorne Parnes on 19 November 2004. These notes are licensed under the FDL.
* [http://www.med.uwo.ca/UME/Diane/Year2Postings2004-2005/Trimester%202/CNS/AcuteFacialNerveParalysisDrParnes.pdf Acute facial nerve paralysis] - Notes from a lecture presented to second year medical school students at the [http://www.uwo.ca/ University of Western Ontario] by Dr. Lorne Parnes on 19 November 2004. These notes are licensed under the FDL.
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== Acknowledgements ==
The content on this page was first contributed by


List of contributors:
[[Facial nerve paralysis history and symptoms|History and Symptoms ]] | [[ Facial nerve paralysis physical examination|Physical Examination]] | [[Facial nerve paralysis laboratory findings|Laboratory Findings]] | [[Facial nerve paralysis other imaging findings|Other Imaging Findings]] | [[Facial nerve paralysis other diagnostic studies|Other Diagnostic Studies]]


== Suggested Reading and Key General References ==
==Treatment==
[[Facial nerve paralysis medical therapy|Medical Therapy]] | [[Facial nerve paralysis surgery |Surgery]] | [[Facial nerve paralysis primary prevention|Primary Prevention]] |[[Facial nerve paralysis secondary prevention|Secondary Prevention]] | [[Facial nerve paralysis cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Facial nerve paralysis future or investigational therapies|Future or Investigational Therapies]]


== Suggested Links and Web Resources ==
==Case Studies==
 
[[Facial nerve paralysis case study one|Case #1]]
== For Patients ==
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[[Category:Oral and maxillofacial surgery]]
[[Category:Oral and maxillofacial surgery]]
[[Category:Otolaryngology]]
[[Category:Otolaryngology]]
[[de:Fazialislähmung]]
[[hr:Kljenuti ličnog živca]]
[[no:Facialisparese]]




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Latest revision as of 03:28, 29 July 2013

Facial nerve paralysis
Moche. Culture Representation of Facial Paralysis. 300 A.D. Larco Museum Collection, Lima, Peru.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Facial nerve paralysis Microchapters

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Overview

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Classification

Pathophysiology

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Epidemiology and Demographics

Risk Factors

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Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

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[2]

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nerve paralysis in the news

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Risk calculators and risk factors for Facial nerve paralysis

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Facial nerve paralysis from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention |Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1


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