facial nerve palsy

facial nerve palsy

a facial nerve palsy is paralysis of the facial nerve.
the facial nerve is the motor supply to the scalp, facial muscles and stapedius. It also supplies taste in the anterior 2/3 of the tongue via the chorda tympani branch.
the course of the facial nerve through the posterior fossa, temporal bone, and parotid gland makes it vulnerable to many neoplastic, traumatic, and infectious events (1)
a peripheral facial paralysis requires a complete head and neck examination including the following:
- otoscopy
- cranial nerve evaluation. (1)
the function of the facial nerve is tested as follows in the neurological examination:
- brow:
  - the patient is asked to raise the eyebrows
  - the brow is spared in a unilateral upper motor neurone lesion - for example a stroke affecting one half of the face will spare the brow
  - if there is an upper motor neurone lesion affecting the facial nerve then the ability to wrinkle the brow is preserved; in Bell's palsy this ability is lost
- eyes:
  - the patient is asked to screw up the eyes and resist attempts by the examiner to open the eyes
- facial movement:
  - smiling, blowing out the cheeks, etc.

Reference:

Last reviewed 01/2018

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