Clinical features
- characteristics of a peripheral facial paralysis ( seen on the affected side) include: (1)
- unable to wrinkle forehead
- unable to raise eyebrow
- unable to wrinkle nasolabial fold
- unable to purse lips or show teeth
- inability to completely close eye
- lacrimation, salivation and taste is likely to be impaired when the lesion is proximal or involving the geniculate ganglion (2)
- when the lesion is distal to the internal auditory canal and geniculate ganglion lacrimation is intact but, salivation and taste is likely to be impaired (2)
- decreased taste - indicates a lesion above origin of the chorda tympani
- hyperacusis -indicates the lesion is above nerve to stapedius
- reduction of lacrimation - indicates the lesion is above the geniculate ganglion
- Bell phenomenon
- on closing the affected eye there is visible vertical rotation of the globe
- characteristics of a central facial paralysis include: (1)
- movements of the frontal and upper orbicularis oculi muscles tend to be spared since there are uncrossed contributions from ipsilateral supranuclear areas
- during emotional expression facial movement may be present on affected side
- lacrimation, taste, and salivation is intact (2)
Reference
- Libreros-Jiménez HM, Manzo J, Rojas-Durán F, et al. On the cranial nerves. NeuroSci. 2024 Mar;5(1):8-38.
- Glass GE, Tzafetta K; Bell's palsy: a summary of current evidence and referral algorithm. Fam Pract. 2014 Dec;31(6):631-42.
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