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Clinical features

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

  • 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)


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