Transcript Facial nerve palsy

Management and classification
Dr.Ishara Maduka
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What is facial nerve
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Structures supplied by facial nerve
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Causes of facial nerve palsy
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Clinical features of facial nerve palsy
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Bells Palsy
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Facial nerve is the VIIth cranial nerve.
It’s a mixed cranial nerve. It means it has
both sensory and the motor components.
It originates at the level of pons in brain stem
and exit the cranial cavity through
stylomastoid foramen and enter into parotid
gland.
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Tearing -- Lacrimal Gland
Taste -- Anterior 2/3 of the Tongue
Saliva Production -- Sublingual Gland,
Submandibular Gland,
Nasal and Palatine Gland
Muscles of Facial Expression
Stapedius Muscle -- A muscle which helps to
protect the ear from loud noises.
Contains a few somatic afferent fibers.
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Frontalis Innervates the
Forehead muscles
Orbicularis Oculi Eyelid muscles
Orbicularis Oris Lip muscles
Supranuclear
Infranuclear
Strokes
Bells palsy
(Commonest)
Trauma
Herpes Zoster
Otitis media
Parotid gland tumour
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Facial asymmetry
Eyebrow droop
Loss of forehead & nasolabial folds
Drooping of corner of mouth
Uncontrolled tearing
Inability to close eye
Lips not held tightly together: Difficulty
keeping food in mouth
Facial muscle atrophy (Late)
What’s the difference between supranuclear
and infranuclear facial nerve palsy.
In Supranuclear palsy – paralysis is limited to
the lower half of the face.
In infranuclear palsy – paralysis affects the
whole face
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Homework?
The upper half of the face receives nerve
supply from both sides.
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Depend on the cause. Treatment of the cause
will relieve symptoms.
E.g. – Otitis media – Antibiotics, drainage
 Tumour - Excision
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Bell's palsy is thought to be due to swelling
(inflammation) of this nerve in the area where
it travels through the bones of the skull.
The cause is often not clear. (Idiopathic) A
type of herpes infection called herpes
zoster might be involved.
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Corticosteroids
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Anti- viral medications: E.g. Acyclovir
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Protect eye from exposure
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Facial exercise – Facial retraining
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Find out about the facial retraining
techniques.