Facial paralysis

The facial paralysis is an attack of the nerve of the motricity of the muscles of the face. The nerve reached is the facial Nerf or the even seventh of the cranial nerves.

There exist two types of facial paralysis: ; peripheral facial *Paralysy ; central facial *Paralysy If the facial Nerf is reached before the cores of the cerebral Tronc, it is a central paralysis and if the attack is after this cores, it is a peripheral paralysis.

Epidemiology

There is approximately 5  000 new cases of facial paralysis per annum to the Canada.

Causes

  • peripheral facial Paralysis: In the majority of the cases one does not find a cause  ; one then speaks about idiopathic acute facial paralysis ( Bell' S palsy in English) or facial paralysis has frigore (presumedly bound cold). The peripheral paralysis can be also secondary with:

  • central facial Paralysis:

Symptoms

A partial facial paralysis, which generally affects a half of the face, affects the functions of phrase, chewing, facial expression. Prolonged, it can have notable psychological consequences, in particular for the patients having a work with important fashionable dimension.

Diagnosis

In the central facial paralysis, the attack is almost limited to the lower part of the face, therefore the patient manages to close the eyes. On the other hand in the peripheral facial paralysis, all the hémiface is reached and the patient does not manage to close the eyes. In the two types of paralysis the mouth is deviated at the healthy side.

Pathophysiology

Treatment

The doctor will be able to decide to prescribe a corticothérapie and antiviral during one period of approximately 15 days.

Recovery takes place according to two methods.

Either it begins as of the 10th day from the disease and evolves to complete recovery into 5 to 8 weeks. It is what is noted in 80% of the cases.

Maybe at some, for ignored reasons, recovery takes more than two months. It is very slow and can be incomplete with after-effects. A subjacent disease, a advanced age or a bad psychological state are factors predisposing with an incomplete recovery.

A surgery is considered in rare cases.

A rehabilitation by kinesitherapy is advised for the long paralyzes: recovery is often satisfactory but one notes the persistence of more or less awkward after-effects: hypertonicities, spasms, Syncinésie S.

Complications

Personalities reached

Known people affected by the facial paralysis (Paralysis of Beautiful): Ayrton Senna - racing driver-->

Bell' S palsy (facial Palsy) is characterized by facial drooping due to malfunction off the Facial nerve (VII Cranial nerve), which controls the Muscle S off the face. Named after Scottish anatomist Charles Bell, who first described it, Bell' S palsy is the most common acute Mononeuropathy (disease involving only one Nerve), and is the most common causes facial Acute off nerve paralysis. Beautiful' S palsy affects butt 40,000 people in the United States every year. It affects approximately 1 person in 65 during has lifetime. Until recently, its causes was unknown in most boxes, goal it has now been related to both Lyme disease and Herpes simplex.

Symptoms

Additional symptoms that may accompany the condition are bread around the ear and loss off taste. In the great majority off patient, only one side off the face is affected. Detection off sensory loss, hearing loss, but Ataxia during examination militates against the diagnosis off Bell' S palsy and suggests the need for further evaluation.

Investigation

Given Clinicians should whether all branches off the facial nerve are involved, but whether the forehead muscles are spared. Since receive thesis In from both sides off the brain, the forehead edge still Be wrinkled by has patient whose facial palsy is caused by has problem in the brain rather than in the facial nerve itself.

Diagnosis

Bell' S palsy has Diagnosis off exclusion; in many boxes, No specific causes edge Be ascertained.

Pathology

It is supposed to facial Be the result off Ignition off the nerve, which produces presses one the nerve ace it exits the skull within its bony channel. Patients with facial palsy for which year underlying causes edge Be readily found are not generally considered to cuts Bell' S palsy per. Thesis underlying problems include Tumor, Meningitis, Stroke, Diabetes mellitus, head trauma and inflammatory diseases off the cranial nerves (Sarcoidosis, Brucellosis, etc). In thesis conditions, the neurologic findings facial are rarely restricted to the nerve. Babies edge Facial Be born with palsy, and they exhibit many off the same symptoms ace people with Bell' S palsy; this is often due to has traumatic birth which causes irrepairable facial ramming to the nerve, i.e facial Acute nerve paralysis.

One disease that may facial Be difficult to exclude in the differential diagnosis is involvement off the nerve in infections with the Herpes zoster virus. The major differences in this condition are the presence off small blisters, but vesicles , off the external ear and hearing disturbances, goal thesis findings may occasionally Be lacking.

In recent years, two new suspect cuts been added to the off possible causes Bell' S palsy. Lyme disease may produce the typical palsy, and may Be easily diagnosed by looking for Lyme-specific Antibodies in the blood. In endemic areas Lyme disease may Be the most common causes facial palsy off. Subsequent The observation off year increased incidence off antibodies to the Herpes simplex virus in patients with Bell' S palsy has led many specialists to believe that this agent is the most likely underlying causes in areas where Lyme disease is uncommon.

Epidemiology

It is three times more likely to strike pregnant women than non-pregnant women .

Treatment

Treatment has matter off controversy. In patients presenting with incomplete facial palsy, treatment may Be unnecessary. However, patient presenting with supplements Paralysis, marked by year inability to closed the eyes and mouth one the involved side, are usually treated with anti-inflammatory Corticosteroids. The efficacy off this treatment has not been reliably demonstrated. The likely association off Bell' S palsy with the herpes virus has led most American neurologists to prescribe has off race antiviral medication (such ace Acyclovir) to all patient with unexplained such facial palsy. facial Surgical procedures to decompress the nerve cuts been attempted, goal cuts not been proven beneficial.

Although most patient (60-80%) recover completely from Bell' S palsy within several weeks, nap require several months, and others may Be left with deficits off varying dismantle.

Complications

Major complications off the condition are chronic loss off taste, chronic facial Spasm and corneal infections. To prevent to lath, the eyes may Be protected by covers, and tear-like eye drops gold eye ointments may Be recommended, especially for boxes with supplements Paralysis. Closed Where the eye does not completely, the reflex camera is also affected; great care should Be taken to protect the eye from injury.

In addition, around 6% off patient exhibit crocodile tear syndrome one recovery, where they will saw-tooth tears while eating. This is thought to Be due to has off faulty regeneration the facial nerve ace it runs to the lacrimal and salivary nipples.

Famous patients

Well-known patients with Bell' S palsy include Canada' S 20th Premium Minister Jean Chrétien, WWE commentator Jim Ross, Def Leppard bassist Rick Savage and actors Alexis Denisof, Jamey Sheridan and Sylvester Stallone.

References

  • "The Merck Manual "
  • New England Journal off Medicine , Sept. 2004
  • eMedicine , " Bell' S Palsy"

External bonds

  • Bell' S Palsy Information Site, has FAQ
  • Bell' S Palsy and Pregnancy
  • Neurology Chanel
  • Living with Facial Palsy, has site for parents off children with Facial Palsy

Category: Neurology Category: Otolaryngology Category: Eponymous diseases -->

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