A 44-Year-Old Man with Bilateral Facial Droop

2016 ◽  
Author(s):  
Jeffrey A. Cohen ◽  
Justin J. Mowchun ◽  
Victoria H. Lawson ◽  
Nathaniel M. Robbins
Keyword(s):  
Lyme Disease ◽  
Motor Neuron ◽  
Facial Palsy ◽  
Clinical Findings ◽  
Acute Onset ◽  
Lower Motor Neuron ◽  
Facial Weakness ◽  
Facial Paresis ◽  
Peripheral Facial Palsy ◽  
Work Up

Facial neuropathy is most commonly seen as an idiopathic unilateral palsy known as Bell’s palsy. Generally, acute onset of typical lower motor neuron facial weakness that is not associated with other atypical or suspicious features, remains unilateral, and recovers completely requires no further workup. A recurrent or bilateral peripheral facial palsy makes an idiopathic cause less likely and prompts a more in-depth workup. The appropriate work-up of unilateral or bilateral facial palsy guided by the presence or absence of associated clinical findings is discussed. The major differentials for bilateral facial paresis include brainstem (especially pontine and prepontine) tumors, Lyme disease (especially in endemic areas), basal menigitides, Guillain-Barre syndrome, and sarcoidosis.

Etiopathogenesis of lower motor neuron facial palsy: Our experience

2011 ◽  
Vol 17 (2) ◽  
pp. 58
Author(s):  
M Venugopal ◽  
R Suma ◽  
Sheeja Rajan ◽  
Subin Thomas
Keyword(s):  
Motor Neuron ◽  
Facial Palsy ◽  
Lower Motor Neuron

scholarly journals A rare case of acquired infantile Bell’s palsy

2021 ◽  
Vol 8 (7) ◽  
pp. 1316
Author(s):  
Lakshmi Mulinja ◽  
Thanzir Mohammed ◽  
Varun Govindarajan ◽  
Mallesh Kariyappa
Keyword(s):  
Case Report ◽  
Facial Palsy ◽  
Rare Case ◽  
Bell’S Palsy ◽  
Acute Onset ◽  
Spontaneous Resolution ◽  
Bell's Palsy ◽  
Peripheral Facial Palsy ◽  
Oral Corticosteroids ◽  
Viral Illness

Bell’s palsy, an acute onset, acquired, isolated peripheral facial palsy, usually follows a viral illness, is common disorder post infancy to adolescence. It has a favourable prognosis with spontaneous resolution, or with use of oral corticosteroids. Its presentation in early infancy is very unusual, as in our case report of 3 month old infant with an ovoid mass lesion in parotid, which disappeared after therapy with corticosteroids with no residual deficit.

scholarly journals Recurrent lower motor neuron type facial palsy: an unusual manifestation of SLE

2011 ◽  
Vol 2011 (jan29 1) ◽  
pp. bcr1220103564-bcr1220103564
Author(s):  
D. K. Gupta ◽  
V. Atam ◽  
S. C. Chaudhary
Keyword(s):  
Motor Neuron ◽  
Facial Palsy ◽  
Lower Motor Neuron ◽  
Neuron Type ◽  
Unusual Manifestation

Facial Palsy, Radiographic and Other Workup Negative: FROWN

2020 ◽  
pp. 10.1212/CPJ.0000000000001020
Author(s):  
Jacqueline J Greene ◽  
Reza Sadjadi ◽  
Nate Jowett ◽  
Tessa Hadlock
Keyword(s):  
Facial Nerve ◽  
Facial Palsy ◽  
Malignant Tumors ◽  
Malignant Neoplasm ◽  
Acute Onset ◽  
Peripheral Facial Palsy ◽  
Facial Reanimation ◽  
Term Evaluation ◽  
Slow Onset

AbstractObjectives:Slow-onset peripheral facial palsy is far less common than acute-onset peripheral facial palsy and necessitates diagnostic evaluation for a benign or malignant tumors, or other less common etiologies. In the rare scenario when no clarifying etiology is discovered following long-term evaluation (no radiographic or hematologic abnormalities and an otherwise unremarkable evaluation), a diagnostic and management dilemma occurs. We present a series of patients with this possible new clinical entity: facial palsy, radiographic and other workup negative (FROWN), and propose a management strategy for this diagnosis of exclusion.Methods:A series of 3,849 patients presenting with facial palsy to a tertiary Facial Nerve Center was retrospectively assessed to identify those with progressive loss of facial function over at least 1 month. Exclusion criteria included history, physical or hematologic findings indicative of known diseases associated with facial palsy, and radiographic studies demonstrating a benign or malignant tumor.Results:Patients with slow-onset facial palsy constituted 5% (190 patients) of the cohort and were ultimately diagnosed with either a benign or malignant neoplasm or other facial nerve pathology. Fourteen patients with slow-onset facial palsy remained without a diagnosis following long-term evaluation and serial imaging. Eleven patients underwent dynamic facial reanimation surgery and facial nerve and muscle biopsy, with no clear histopathologic diagnosis.Conclusion:Patients with slow-onset facial palsy with negative radiographic and medical evaluations over several years may be characterized as having FROWN, an idiopathic and as yet poorly understood condition, which appears to be amenable to facial reanimation, but which requires further investigation as to its pathophysiology.

P22.11 EEG as a predictor of Lyme disease in a child with a peripheral facial palsy

2011 ◽  
Vol 15 ◽  
pp. S122
Author(s):  
M. Malenica ◽  
L.J. Cvitanović-Šojat ◽  
R.G. Juraški ◽  
G. Tešović
Keyword(s):  
Lyme Disease ◽  
Facial Palsy ◽  
Peripheral Facial Palsy

Malakoplakia of the temporal bone in a nine-month-old infant

1991 ◽  
Vol 105 (7) ◽  
pp. 568-570 ◽  
Author(s):  
R. C. Nayar ◽  
I. Garg ◽  
J. J. Alapatt
Keyword(s):  
Motor Neuron ◽  
Temporal Bone ◽  
Facial Palsy ◽  
Relevant Literature ◽  
Male Child ◽  
Surgical Debridement ◽  
Lower Motor Neuron ◽  
Bony Labyrinth ◽  
Aural Polyp

AbstractA case of malakoplakia, of the temporal bone in a nine-month-old male child is reported.The lesion presented as an aural polyp, associated with a lower motor neuron facial palsy. On exploration, the granuloma was noted to involve the temporal bone, eroding the bony labyrinth. It was successfully treated with surgical debridement, and antibiotics. A review of the relevant literature is presented.

scholarly journals Non-idiopathic peripheral facial palsy: prognostic factors for outcome

2020 ◽  
Author(s):  
Katharina Geißler ◽  
Elisabeth Urban ◽  
Gerd F. Volk ◽  
Carsten M. Klingner ◽  
Otto W. Witte ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Lyme Disease ◽  
Motor Function ◽  
Facial Palsy ◽  
Recovery Rate ◽  
Complete Recovery ◽  
Prednisolone Therapy ◽  
Peripheral Facial Palsy ◽  
Post Surgery ◽  
Function Tests

Abstract Objectives There is a lack of data on patients’ and diagnostic factors for prognostication of complete recovery in patients with non-idiopathic peripheral facial palsy (FP). Methods Cohort register-based study of 264 patients with non-idiopathic peripheral FP and uniform diagnostics and standardized treatment in a university hospital from 2007 to 2017 (47% female, median age: 57 years). Clinical data, facial grading, electrodiagnostics, motor function tests, non-motor function tests, and onset of prednisolone therapy were assessed for their impact on the probability of complete recovery using univariable and multivariable statistics. Results The most frequent reason for a non-idiopathic peripheral FP was a reactivation of Varicella Zoster Virus (VZV; 36.4%). Traumatic origin had a higher proportion of complete FP (52.9%). Furthermore, in traumatic FP, the mean interval between onset and start of prednisolone therapy was longer than in other cases (5.6 ± 6.2 days). Patients with reactivation of VZV, Lyme disease or otogenic FP had a significant higher recovery rate (p = 0.002, p < 0.0001, p = 0.018, respectively), whereas patients with post-surgery FP and other reasons had a significant lower recovery rate (p < 0.0001). After multivariate analyses voluntary activity in first EMG, Lyme disease and post-surgery cause were identified as independent diagnostic and prognostic factors on the probability of complete recovery (all p < 0.05). Conclusion Infectious causes for non-idiopathic FP like VZV reactivation and Lyme disease had best probability for complete recovery. Post-surgery FP had a worse prognosis. Level of evidence 2

scholarly journals Lower motor neuron facial palsy after ventriculoperitoneal shunt surgery

2015 ◽  
Vol 2015 (apr28 1) ◽  
pp. bcr2014206938-bcr2014206938 ◽  
Author(s):  
R. V. Ramdasi ◽  
V. Rangarajan ◽  
A. Mahore
Keyword(s):  
Motor Neuron ◽  
Ventriculoperitoneal Shunt ◽  
Facial Palsy ◽  
Lower Motor Neuron ◽  
Shunt Surgery
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