1. Management and classification Dr.Ishara Maduka
Facial nerve palsy
Management and classification
Dr.Ishara Maduka

2. Objectives What is facial nerve Structures supplied by facial nerve
Causes of facial nerve palsy
Clinical features of facial nerve palsy
Bells Palsy

3. What is facial nerve 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.

4. Structures supplied by the facial nerve
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.

5. Structures supplied by the facial nerve

6. Structures supplied by the facial nerve
Frontalis - Innervates the Forehead muscles
Orbicularis Oculi - Eyelid muscles
Orbicularis Oris  - Lip muscles

7. Causes of facial nerve palsy
Supranuclear
Infranuclear
Strokes
Bells palsy (Commonest)
Trauma
Herpes Zoster
Otitis media
Parotid gland tumour

8. Clinical features of facial nerve palsy
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)

9. Clinical features of facial nerve palsy
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

10. Reason?
Homework?
The upper half of the face receives nerve supply from both sides.

11. Right sided facial nerve palsy

12. Treatment of Facial nerve palsy
Depend on the cause. Treatment of the cause will relieve symptoms.
E.g. – Otitis media – Antibiotics, drainage
Tumour - Excision

13. Bell’s Palsy
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.

14. Treatment of Bell’s palsy
Corticosteroids
Anti- viral medications: E.g. Acyclovir
Protect eye from exposure
Facial exercise – Facial retraining

15. Assignment
Find out about the facial retraining techniques.