This book describes the Facial Palsy, Diagnosis and Treatment and Related Diseases

Facial Palsy is the pressure on the facial nerve causing paralysis

The cause is unknown but ranged from hereditary to sarcoidosis

The facial muscles on one side is weak and drooping

The eye cannot close properly and there is saliva dribbling

Bell’s Palsy is the most common form of Facial palsy

Smiling usually show up the presence of facial paresis

There is no definitive test available for Bell’s palsy

Physical signs and electromyogram determines the extent of the nerve paralysis

The face is crooked on one side with drooping of the lips

The eye on one side cannot close properly with out turned eyelids

There is blinking or tears in the eye while eating

There is dribbling of saliva and difficulty in talking

The treatment is to start urgently on a course of oral prednisolone

Physiotherapy of the facial muscles is used to restore the facial muscle tone.

The eyes need to be protected by wearing glasses or using eye ointment

Most patients will recover within 3 weeks of treatment

-An original poem by Kenneth Kee

Bell’s facial palsy is the most frequent cause of facial paralysis.

While early medical trials of mRNA COVID-19 vaccines reported a very small number of post-vaccine Bell’s facial palsy cases, later studies detected no relation between the two.

New treatment methods for facial palsy are Facial neuromuscular retraining, Botulinum toxin injection and surgery for post-paralytic syndrome.

Facial Palsy is the paralysis of the facial nerve (7th cranial nerve) from its origin in the brain right to the branches of the nerve in the face.

Bell palsy also termed idiopathic facial paralysis (IFP) is the most frequent cause of unilateral facial paralysis and the most frequent cause of facial paralysis worldwide.

When Facial Palsy happens, the function of the facial nerve is disrupted producing a disruption in the messages the brain transmits to the facial muscles.

This disruption leads to facial weakness or paralysis.

Facial Palsy involves only one of the paired facial nerves and one side of the face but rarely can affect both sides.

The cause of Facial palsy is unknown though the disease seems to be a polyneuritis with possible viral, inflammatory, autoimmune and ischemic causes.

The facial nerve becomes inflamed in reaction to the infection causing pressure within the Fallopian canal and leading to ischemia of the nerve cells.

The minimum diagnostic criteria for facial palsy are paralysis or paresis of all muscle groups on one side of the face, sudden onset and absence of CNS disease.

The most important part of the diagnosis is to distinguish between the supra-nuclear and infra-nuclear causes of facial palsy.

Supra-nuclear

The movements of the upper part of the face is not affected since the forehead muscles have bilateral cortical representations

Infra-nuclear

Weakness of facial muscle on 1 side, with drooping of the mouth on 1 side, sagging eyelids, difficulty in closing the eye.

Some Facial Palsy cases are mild and do not need treatment as the symptoms normally subside on their own within 2 weeks.

Treatment involves:

Corticosteroid therapy

Antiviral agents

Eye care: Topical ocular lubrication to prevent corneal drying, abrasion and ulcers

Physiotherapy

Surgical treatments are:

Facial nerve decompression

Subocularis oculi fat lift

Implantable devices in the eyelid

Tarsorrhaphy

Transposition of the temporalis muscle

Facial nerve grafting

TABLE OF CONTENT

Introduction

Chapter 1 Facial Palsy

Chapter 2 Causes

Chapter 3 Symptoms

Chapter 4 Diagnosis

Chapter 5 Treatment

Chapter 6 Prognosis

Chapter 7 Trigeminal Neuralgia

Chapter 8 Intercostal Neuralgia

Epilogue