Cranial Nerve- VII

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1st: Differentiate between UMN type vs LMN type facial palsy

LMN type Facial palsy 

Whole side of face in Paralyzed

Loss of wrinkling of forehead

Unable t close the eye properly

UMN type facial palsy 

Only lower side of face is affected

Wrinkilng of forehead is intact

Can close the eye Properly

In case of LMN type palsy

  1. Look for visible cause:
    • Parotid gland enlargement
    • Any scar mark in parotid area
    • Signs indicating trauma
  2. Localize the lesion:
    1. Ramsay-Hunt syndrome:
          • Herpetic vesicles in external auditary meatus and soft palate
    2. For lesion in petrous part of temporal bone:
          • Loss of tast in anterior 2/3 of tongue
          • Hyperacusis
    3. Cerebellopontine angle lesion:
          • Associated with 5th and  8th cranial nerve involvement
    4. Pontine lesion:
          • 6th cranial nerve palsy
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