Facial Nerve and About its Disorders

The seventh cranial nerve motor nerve supply mainly facial expression muscles. Sensory component is small, it carries out in front of the tongue, and sensations from the front wall of the external auditory canal 2/3rds of taste sensations. Facial nerve disorders usually supranuclear facial palsy, or nuclear facial paralysis infranuclear (LMN) and Bell's palsy.

Supranuclear facial palsy

Supranuclear or upper motor neuron facial paralysis, only less than half of the face is affected. This is because the nuclear center, which controls the upper facial movements, both ipsilateral and opposite supranuclear center and bottom of the face is just the opposite, or mostly supranuclear innervation. Thus, cortical or subcortical damage to products in the lower part of the opposite side of facial paralysis. Supranuclear Palsy are two types of volitional and emotional.

Volitional paralysis, involvement is the most prominent voluntary contraction. Of automatic involuntary movements, such as crying or smiling, not save. Cortical or subcortical here pyramindal tract illness, as they travel through the internal capsule, cerebral peduncle or pons above the facial nucleus. Mimetic or emotional facial paresis, asymmetry is not mimetic or facial paresis is not a voluntary movement of facial muscles asymmmetry. The patient can close his eyes, his mouth to distract or blow his cheeks without difficulty. However, paresis shows a smiling or crying. Violation here or in front of the precentral cortex, or deep-seated thalamus or basal ganglia, the frontal lobes.

Nuclear infranuclear or facial paralysis (LMN)

Lower motor neurons are the final common path. Here it is damaging the weakness of the entire ipsilateral side of the face side. The exact site of lesion set of related marks. Pontine tumor or abnormal vascular occlusion, facial paralysis is associated with the ipsilateral sixth nerve palsy. Cerebellopontine angle violation, such as acoustic neuroma, is associated with ipsilateral fifth and eighth nerve palsy, cerebella symptoms and signs of the opposite pyramid. During the facial canal can be affected by nerves in various ways. Inflammation, such as herpes zoster can affect the geniculate ganglion.

Other infections such as mumps, scarlet fever and malaria, metabolic diseases like diabetes, alcoholism and nutritional deficiency, metastatic tumors, neuroleukemia, etc., can affect the facial nerve through the facial canal. Since the middle ear, nerve proximity, facial paresis can be otitis media complications fester long bones or mastoiditis. Immediately, at the stylomastoid foramen, nerve to participate in parotid gland tumors, trauma, obstetrical trauma of forceps delivery, etc. Participation in the terminal nerve branches of leprosy, which affects the individual involvement of muscle function. Bilateral facial paralysis is usually due to Guillain-Barr'e syndrome or sarcoidosis.

Bell's palsy

This is the most common cause of facial paralysis LMN. It usually resolves spontaneously, often begins with mild pain in the ear. Sometimes the effects of the cold or wind, and mild systemic infection history. The exact cause is unknown. Believed to be compression or nerve, facial nerve canal ischemia or viral infection or EDMA periosteitis. Sudden onset of illness comes facial palsy, which affects the normal side of the mouth angle deviation, and the inability to close eyelids. Food collects oral vestibule. Paralysis can be dense, involving all the muscles, or may be partial. Most of the patients completely improve facial paralysis.

Small number of cases of paralysis may be permanent. To recover, start showing signs of recovery within a week, and recovery can be completed within a month. Complications include corneal ulceration and exposure keratitis, facial contracture and abnormal innervations recovery. Acute phase of steriods can be tried. However, the Physiotherapy is a key factor in preventing the development of contractures. In cases that do not recover, plastic surgery procedures to reduce the deformity and facial nerve anastomosis glossopharyngeal nerve, was successfully employed.