Thursday, 20 August 2009

facial nerve palsy


Look for:
Forehead wrinkles
Nasolabial folds
Watch spontaneous movements –smiling, blinking
Ask pt to do:
• Show his teeth
• Whistle
• Close his eyes tight and try to open
• Look up the ceiling & look for symm movt
• Compare strength of fore head and lower face.
LMN lesion:
• In LMN facial palsy the whole half of the face
in the affected side is involved.
• Causes:
1. Idiopathic (Bell’s palsy)
2. Herpes Zoster
3. Parotid tumour
4. CP angle tumour
5. Skull fracture
Look for the cause in LMN lesion
• Look at the external auditory meatus
• Look for parotid gland enlargement
• Examine the tympanic membrane
• Check for hearing (hyperacusis)
• examine for taste
• Test urine for sugar



UMN lesion:
• In UMN facial palsy the upper part of the face is spared
(due to bilateral inervation of the nucleus)
• Causes:
1. stroke
2. Intracranial tumour
3. MS
4. vasculitides

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