Felis ISSN 2398-2950

Facial nerve neuropathy

Synonym(s): Facial palsy

Contributor(s): Agnes Delauche, Agnes Delauche, Robin Franklin, Laurent Garosi

Introduction

  • Uni or bilateral facial paralysis or paresis.
  • Cause: immune-mediated , inflammation, eg otitis media/interna, middle ear polyps, infection , myasthenia gravis, toxins , eg botulism , trauma, eg brain trauma, primary or metastatic brain tumor, middle ear tumor, rarely, idiopathic.
  • Signs: drooping and inability to move the ear and lip, drooling, widened palpebral fissure, absent abduction of nostril during inspiration, deviation of nose towards normal side, absent spontaneous or provoked blinking.
  • Treament: symptomatic for the facial nerve paralysis, specific treatment for the primary disease may reverse the facial neuropathy.
  • Prognosis: variable depending on inciting cause.

Pathogenesis

Etiology

Pathophysiology

  • Degeneration of facial nerve.
  • The facial canal that is adjacent to the tympanic cavity lacks a bony wall for a very short distance as it runs in the petrosal portion of the temporal bone. This leaves the facial nerve exposed to the cavity, and therefore to disease processes affecting the middle ear.
  • Inciting cause   →   axonal damage especially of large diameter myelinated fibers   →   loss of function   →   paresis/paralysis of facial muscles.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

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