1. FACIAL NERVE
ANATOMY :
LESIONS OF FACIAL NERVE
• UNILATERAL FACIAL PALSY
- Neoplasms and vascular accidents
- Unilateral LMN facial palsy eg. Bell’s palsy, parotid tumor, DM
• BILATERAL FACIAL PALSY
- B/L UMN palsy – Motor neuron disease, cerebro vascular accident
- B/L LMN palsy – GBS, PMA, Sarcoidosis , Lyme disease, Leprosy
DIFFERENCE BETWEEN UMN AND LMN FACIAL PALSY
BILATERAL UMN PALSY BILATERAL LMN PALSY
Bell’s phenomenon is absent Bell’s phenomenon is present
Emotional fibres are spared Emotional fibres are affected
Associated with long tract signs Long tract signs are absent
Jaw jerk is exaggerated Jaw jerk is normal
Corneal reflex is present Corneal reflex is absent
SYNDROMES ASSCOCIATED WITH FACIAL PALSY
1. Melkersson-Rosenthal syndrome - Recurrent facial palsy, facial edema, plication of the tongue
2. Moebius syndrome - Congenital aplasia of 6th
and 7th
cranial nerve, ipsilateral LMN facial palsy with impairment of salivary and lacrimal secretion.
3. Millard-Gubler syndrome - Ipsilateral LMN facial plasy, Ipsilateral lateral rectus palsy, Contralateral hemiparesis.
4. Fovilles syndrome - Ipsilateral LMN facial palsy, Ipsilateral lateral gaze palsy, Contralateral hemiparesis
5. Ramsay hunt syndrome - Herpes Zoster of geniculate ganglion.
6. Brocardts syndrome (Crocodile tear syndrome) - It is a paradoxical gustatory lacrimal reflex that occurs due to faulty innervations of lacrimal glands
from secretomotor fibres of salivary glands.
Dr. SABAREESH J 3RD
YEAR PG