Diferencia entre revisiones de «Facial paralysis»
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==Evaluation== | ==Evaluation== | ||
Central Process | |||
*CT | |||
Peripheral Process | |||
*No labs or imaging routinely necessary | |||
*Consider lyme serologies if endemic area | |||
==Management== | ==Management== | ||
Revisión del 02:15 21 sep 2018
Background
- Key to distinguish between central and peripheral facial nerve palsy
- Central
- CVA
- Peripheral
- Idiopathic (Bell's palsy)
- Lyme disease
- Varicella zoster
- HSV
- Facial trauma
Clinical Features
Central Process
- Forehead "sparing" or normal muscle tone of the forehead
Peripheral Process
- Weakness of forehead muscles
Central and Peripheral
- Unable to close eye
- Loss of nasolabial fold
- Asymmetric smile
Differential Diagnosis
Facial paralysis
- Bell's palsy
- CVA
- Trigeminal neuralgia
- Tick paralysis
- Herpes zoster oticus (Ramsay Hunt syndrome)
- CNS tumor
- Acoustic neuroma or other cerebellopontine angle lesions
- Meningioma
- Cerebellar pontine angle
- Facial nerve schwannoma
- Parotid
- Sarcoma
- Anesthesia nerve blocks
- Cerebral Aneurysms (vertebral, basilar, or carotid)
Evaluation
Central Process
- CT
Peripheral Process
- No labs or imaging routinely necessary
- Consider lyme serologies if endemic area
Management
Central Process
- CT
Peripheral Process
- No labs or imaging routinely necessary
- Consider lyme serologies if endemic area