Facial Nerve Palsy - Neurologic Disorders - MSD Manual Professional Edition
A facial palsy is weakness or paralysis of the muscles of the face. Figure 1 — The course and intracranial branches of the facial nerve.
Many causative associations have been proposed, the most universally accepted theory suggests a viral originyet no conclusive evidence is available at present.
Nerve on the severity and the proximity of the nerve lesion, it can also result in:. Patient reassurance is essentialas most cases return spontaneously to full function. All patients presenting anal massage 72 hours of symptoms onset should be started oral steroids.
Current NICE guidance recommends either:.
Facial nerve palsy
Use of anti-viral agents is controversial. There are surgical options available for patients who have persistent weakness or synkinesis. Synkinesis could be treated with botox injections whilst persistent weakness can be treated with anterior belly of diagastric transfer, fascia lata sling, facial cross-facial nerve grafting.
A referral to ophthalmology should be made if the cornea remains exposed after attempting to close the eyelid House Brackmann grade of IV or more. The factors that suggest a poor prognosis from a facial palsy include:.
Figure 4 — An illustration of the auricular vesicles seen in a case of Ramsay-Hunt syndrome. It typically initially presents with a moderate to severe ear pain with few other overt clinical signs.