Diferencia entre revisiones de «Facial paralysis»
Sin resumen de edición |
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| Línea 8: | Línea 8: | ||
**Idiopathic ([[Bell's palsy]]) | **Idiopathic ([[Bell's palsy]]) | ||
**[[Lyme disease]] | **[[Lyme disease]] | ||
**[[Varicella zoster]] | **[[Varicella-zoster]] | ||
**[[HSV]] | **[[HSV]] | ||
**[[Facial trauma]] | **[[Facial trauma]] | ||
| Línea 30: | Línea 30: | ||
==Evaluation== | ==Evaluation== | ||
===Central Process=== | ===Central Process=== | ||
*CT | *[[head CT|CT]] | ||
===Peripheral Process=== | ===Peripheral Process=== | ||
| Línea 38: | Línea 38: | ||
==Management== | ==Management== | ||
===Central Process=== | ===Central Process=== | ||
*Treat underlying pathology | |||
===Peripheral Process=== | ===Peripheral Process=== | ||
* Prednisone (unless diagnosed Lyme disease) | * [[Prednisone]] (unless diagnosed Lyme disease) | ||
* Empiric doxycycline if high suspicion for Lyme disease | * Empiric [[doxycycline]] if high suspicion for Lyme disease | ||
* Consider valacyclovir for severe presentation if Lyme is negative | * Consider [[valacyclovir]] for severe presentation if Lyme is negative | ||
* Artificial tears | * Artificial tears | ||
* Consider neurology follow-up | * Consider neurology follow-up | ||
| Línea 58: | Línea 58: | ||
[[Category:Symptoms]] | [[Category:Symptoms]] | ||
[[Category:Neurology]] | |||
Revisión del 23:36 1 oct 2019
Background
- Key to distinguish between central and peripheral facial nerve palsy
Causes
- Central
- 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
Peripheral Process
- No labs or imaging routinely necessary
- Consider lyme serologies if endemic area
Management
Central Process
- Treat underlying pathology
Peripheral Process
- Prednisone (unless diagnosed Lyme disease)
- Empiric doxycycline if high suspicion for Lyme disease
- Consider valacyclovir for severe presentation if Lyme is negative
- Artificial tears
- Consider neurology follow-up