1. Facial Nerve Nerve anatomy USUHS; Yale. Facial nerve paralysis Signs. Facial asymmetry Return to Cranial nerve disorders. Go to facial paralysis (Baylor) References. 1 http://www.neuro.wustl.edu/neuromuscular/nanatomy/vii.htm

Front Search Index Links ... Patient Info FACIAL NERVE (VII) DISORDERS Anatomy Bell's palsy Differential diagnosis Facial nerve: Anatomy 2 roots Motor from facial nucleus Nervus intermedius Preganglionic parasympathetics (from superior salivatory nucleus) Branches Nerve to stapedius muscle Chorda tympani: Taste Sensory auricular branch Some axons may arise from vagus (Arnold's nerve) Motor: Facial muscles Facial nerve: Anatomical Diagram External link Brainstem anatomy Nerve anatomy: USUHS Yale Facial nerve paralysis: Signs Facial asymmetry Eyebrow droop Drooping of corner of mouth Uncontrolled tearing Inability to close eye Lips cannot be held tightly together: Diificulty keeping food in mouth Facial muscle atrophy (Late) Facial Paresis: Left Bell's Palsy Epidemiology Lifetime prevalence: 6.4 per 1,000 Incidence: Increased with age Overall: 0.5 per year per 1,000 Age 20: 0.1 per year per 1,000 Age 80: 0.6 per year per 1,000 Male = Female Recurrence: 7% Side: Right in 63% ? Increased incidence with diabetes Clinical Features Onset Paralysis: Progresses over 3 to 72 hours Pain (50%): Near mastoid process Excess tearing (33%) Other: Hyperacusis; Dysgeusia

2. Bell's Palsy Home Page - National Centers For Facial Paralysis - Specialists In Bells Palsy Treastments The National Centers For facial paralysis, Inc. (Specialists in the Rehabilitation of Paralyzed Facial http://www.bellspalsy.com/

Specialists in the Rehabilitation of Paralyzed Facial Muscle Contact NCFP This site was last modified: May 03, 2002 800 x 600 resolution FastCounter by bCentral Website: Hayden Web Design

3. Facial Paralysis Core Curriculum Syllabus. facial paralysis. I. ANATOMY OF THE 7TH CRANIAL NERVE. III. DIFFERENTIAL DIAGNOSIS OF PERIPHERAL facial paralysis. http://www.bcm.tmc.edu/oto/studs/face.html

Core Curriculum Syllabus FACIAL PARALYSIS I. ANATOMY OF THE 7TH CRANIAL NERVE Anatomy of the facial nerve and fallopian canal Intracranial nerve arises near pons and courses 12mm to porus acousticus. Meatal portion (10 mm) is anterior to the superior vestibular nerve and superior to the cochlear nerve. Intratemporal portion Labyrinthine segment (3-4 mm) passes through narrowest part of the fallopian canal. Common site of pathology: temporal bone fractures and Bell's palsy. Tympanic segment runs from geniculate ganglion to pyramidal turn (11 mm). Mastoid segment descends 13 mm to exit the stylomastoid foramen. Extracranial portion Nerve extends 15-20 mm from stylomastoid foramen to pes anserinus. Variable branching patterns. Clinical comment: The course of the facial nerve through the posterior fossa, temporal bone, and parotid gland renders this cranial nerve vulnerable to many neoplastic, traumatic, and infectious events. Disorders of the nerve provoke some interest in other medical specialties, but because of his background in head and neck anatomy and pathology and skill in temporal bone surgery, the otolaryngologist is most qualified to diagnose and manage paralysis of the facial nerve. Nevertheless, all clinicians should be able to recognize a peripheral paralysis and initiate proper evaluation. Anomalous Courses Most common anomaly: dehiscence of facial canal.

4. MedlinePlus Medical Encyclopedia: Facial Paralysis facial paralysis. Definition Return to top. facial paralysis is the total loss of voluntary muscle movement of one side of the face. Considerations Return to top. http://www.nlm.nih.gov/medlineplus/ency/article/003028.htm

@import url(http://www.nlm.nih.gov/medlineplus/images/advanced.css); Skip navigation Medical Encyclopedia Other encyclopedia topics: A-Ag Ah-Ap Aq-Az B-Bk ... Z Facial paralysis Contents of this page: Illustrations Alternative names Definition Considerations ... What to expect at your health care provider's office Illustrations Ptosis, drooping of the eyelid Facial drooping Alternative names Return to top Paralysis of the face Definition Return to top Facial paralysis is the total loss of voluntary muscle movement of one side of the face. Considerations Return to top Facial paralysis in adults is often due to Bell's palsy . This disorder (probably derived from a virus) usually affects one side of the face causing a drooping mouth, drooling , and excessive tearing from one eye. While the facial distortion usually improves over time, there may be some permanent deformity. Sometimes there is loss of taste on the affected side of the face. Sound may also be louder on the affected side. In facial paralysis due to stroke , the eye on the affected side can be closed and the forehead can be wrinkled. This is not possible with Bell's palsy. Other muscles on one side of the body may also be involved with a stroke. Facial paralysis due to a brain tumor generally develops gradually with accompanying headaches seizures , or hearing loss.

5. Facial Paralysis facial paralysis Menu. This is a webforum to discuss and comment on facial paralysis. Click here to Enter a new Neurology WebForum article Click Here to Read our Forum Disclaimer and Statement of http://neuro-www.mgh.harvard.edu/forum/FacialParalysisMenu.html

Facial Paralysis Menu This is a webforum to discuss and comment on Facial Paralysis. Click here to Enter a new Neurology WebForum article... This Web Forum is not moderated in any sense. Anyone on the Internet can post articles or reply to previously posted articles, and they may do so anonymously. Therefore, the opinions and statements made in all articles and replies do not represent the official opinions of MGH and MGH Neurology. Neither is MGH or MGH Neurology responsible for the content of any articles or replies. No messages are screened for content. - Very Important Message! - Please Click Here to Read Current Posts: Nov 13, 1997 to Present Useful Websites can be found and posted here! (1/13/00) 7:09 PM RIGHT SIDED PARALYSIS (1/4/00) 9:27 AM reflex sympathetic distrophy (1/3/00) 4:20 PM ... cross face nerve graft surgery (11/14/97) 11:32 AM IMPORTANT: If this page seems to be missing recently added documents, click the "Reload Page" button on your Web Browser to update the menu. Return to the main Neurology WebForum Page. These forums are maintained by the Department of Neurology at Massachusetts General Hospital John Lester - Webspinner

6. Facial Paralysis facial paralysis. A paralysis or weakness of one side of the face can be an alarming and depressing event in ones life. At first it conjures up the notion of having developed a stroke, when in fact http://www.earsite.com/facial_paralysis

7. Eyelid Surgery In Facial Paralysis (Bell's Palsy) of some surgical procedures currently available. Site is accessible for people with low vision....... http://www.eyelid.com/paralysis-bell's.html

Neigel Center for Cosmetic and Laser Surgery Please go to our redesigned web site by clicking here. Eyelid Surgery in Facial Paralysis (Bell's Palsy) Patients with facial paralysis either from Bell's Palsy or neurosurgery such as for acoustic neuroma can certainly benefit from eyelid surgery. The facial paralysis, usually on just one side of the face, can cause many different problems of the eyelid and facial skin and muscles. Because the forehead on the paralyzed side of the face has no wrinkles and is unable to raise that eyebrow, the eyebrow droops, which tends to push the eyelid tissues down either over the eyelashes or over the eye. Although the eyelid itself can open, it has difficulty closing, leading to exposure of the eye, decreased blink, dry eye and in severe cases, corneal ulcers and loss of the eye with perforation from infection. The lower eyelid, because it lacks muscle tone from the loss of nerve stimulus, droops and may even start to turn out (ectropion). The cheek and mouth muscles also droop, which can lead to drooling and trouble with eating and drinking, not to mention loss of the smile on the affected side. Some of these conditions can be corrected with eyelid surgery.

8. Acute Facial Nerve Paralysis Acute Facial Nerve Paralysis. PD Warrick BScPhm, Meds '98 McMaster University. Reviewed by Barry Maber MD FRCSC, Clinical Associate Professor (Otolaryngology), College of Medicine, University of Saskatchewan. Anatomy may be more prone to facial paralysis secondary to Bell's palsy, HZO, or in late disease, systemic http://icarus.med.utoronto.ca/carr/manual/afnp2.html

Acute Facial Nerve Paralysis PD Warrick BScPhm, Meds '98 McMaster University Reviewed by Barry Maber MD FRCSC, Clinical Associate Professor (Otolaryngology), College of Medicine, University of Saskatchewan Anatomy The complex anatomy of the seventh cranial nerve and its subsections must be understood in order to discriminate among the peripheral causes of facial nerve palsy, and to differentiate these from central etiologies. Subsections of the Facial Nerve Supranuclear - from the precentral (motor) and postcentral (sensory) gyri through the genu of the internal capsule to the facial nucleus in the pons (ipsilateral and contralateral nucleus for upper face, contralateral only for lower face) Nuclear - facial nerve travels dorsomedially toward 4 th ventricle, loops laterally around abducent nucleus, then exits anterolaterally and inferiorly at the medullopontine junction Cerebellopontine angle (CPA) - travels with nervus intermedius (NI), alongside CN V, VIII to internal auditory canal Intratemporal Internal auditory canal (ICA) - travels anterosuperiorly with NI within canal for 5-12 mm alongside cochlear, vestibular nerves; lateral-most portion is surrounded by thicker periosteum

9. MEI: Facial Nerve Paralysis Patient Brochure FACIAL NERVE PARALYSIS. A DISCUSSION OF FACIAL NERVE PROBLEMS. There are a number of surgical procedures that are helpful for patients with facial paralysis. http://www.michiganear.com/library/brochures/facial/

FACIAL NERVE PARALYSIS A DISCUSSION OF FACIAL NERVE PROBLEMS Twitching, weakness or paralysis of the face is a symptom of some disorder involving the facial nerve. It is not a disease in itself. The disorder may be caused by many different disease, including circulatory disturbances, injury, infection or tumor. Facial nerve disorders are accompanied by a hearing impairment. This impairment may or may not be related to the facial nerve problems. Hearing is measured in decibels (dB). A hearing level of to 25 dB is considered normal hearing for conversational purposes. FUNCTION OF THE FACIAL NERVE The facial nerve resembles a telephone cable and contains hundreds of individual nerve fibers. Each fiber carries electrical impulses to a specific facial muscle. Acting as a unit this nerve allows us to laugh, cry, smile or frown, hence the name, "the nerve of facial expression". Each of the two facial nerves not only carries nerve impulses to the muscles of one side of the face, but also carries nerve impulses top the tear glands, saliva glands, to the muscle of a small middle ear bone (stapes) and transmits taste fibers from the front of the tongue and pain fibers from the ear canal. As such, a disorder of the facial nerve may result in twitching, weakness or paralysis of the face, dryness of the ear or the mouth, loss of taste, increased sensitivity to loud sound and pain in the ear. An ear specialist is often called upon to manage facial nerve problems because of the close association of this nerve with the ear structures. After leaving the brain the facial nerve enters the temporal bone (ear bone) through a small bony tube (the internal auditory canal) in very close association with the hearing and balance nerves. Along its inch and a half course through a small bony canal in the temporal bone the facial nerve winds around the three middle ear bones, in back o the eardrum, and then through the mastoid to exit below the ear. Here is divides into many branches to supply the facial muscles. During its course through the temporal bone the facial nerve gives off several branches: to the tear gland, to the stapes muscle, to the tongue and saliva glands and to the ear canal.

10. Bell's Palsy InfoSite & Forums: Bells Palsy / Facial Paralysis FAQs Information including diagrams about the causes, symptoms, effects and treatment of Bell's palsy. Also information on Ramsey Hunt Syndrome and other types of facial paralysis. http://www.bellspalsy.ws

Visitor# WHAT IS BELL'S PALSY? Bells palsy is a condition that causes the facial muscles to weaken or become paralyzed. It's caused by trauma to the 7th cranial nerve, and is not permanent. WHY IS IT CALLED BELL'S PALSY? The condition is named for Sir Charles Bell, a Scottish surgeon who studied the nerve and its innervation of the facial muscles 200 years ago. HOW COMMON IS BELL'S PALSY? Bells palsy is not as uncommon as is generally believed. Worldwide statistics set the frequency at just over .02% of the population (with geographical variations). In human terms this is 1 of every 5000 people over the course of a lifetime and 40,000 Americans every year. IS BELL'S PALSY ALWAYS ON THE SAME SIDE? The percentage of left or right side cases is approximately equal, and remains equal for recurrences. IS THERE ANY DIFFERENCE BECAUSE OF GENDER OR RACE? The incidence of Bells palsy in males and females, as well as in the various races is also approximately equal. The chances of the condition being mild or severe, and the rate of recovery is also equal. WHAT CONDITIONS CAN INCREASE THE CHANCE OF HAVING BELL'S PALSY?

11. Spring1998 The Pittsburgh center describes relaxation techniques and tips for improving photographs of the paralyzed face. Also biographies of staff members at the time the newsletter was published. http://www.upmc.edu/FacialNerve/Newsletters/spring_1998.htm

Spring 1998 Vol . 1, No. 2 In this issue: Who's Who? Loosen Up: Four Techniques to Promote Facial Muscle Relaxation "Seen:" from the Facial Nerve Center To Be Presenting: ... Announcements Who's Who? Dr. Ernest K. Manders recently served as Professor of Surgery and Pediatrics in the College of Medicine of the Pennsylvania State University in Hershey. He is currently Professor of Surgery at the University of Pittsburgh. Dr. Manders was born in Ocean Falls, British Columbia, Canada, and immigrated to the United States. He is now a naturalized US citizen. Dr. Manders received his undergraduate education at Harvard College and then attended Harvard Medical School. After a surgical internship at the University of Michigan, he worked for two years as a Research Associate in the Laboratory of Viral Oncology at the National Institutes of Health. He then returned to the University of Michigan where he completed his training in general surgery and plastic surgery. He joined the faculty at Penn State in 1981, and the University of Pittsburgh faculty in 1997. His wife Sandra and he have four children, three sons and a daughter, of whom they are very proud. Mrs. Manders served on the local school board. Dr. Manders is a member of the American College of Surgeons, the American Society of Plastic and Reconstructive Surgeons, the American Association of Plastic Surgeons, the Plastic Surgery Research Council, and is an honorary member of the Society of Plastic and Reconstructive Surgeons of Southern Africa, and the Brazilian Society of Plastic and Reconstructive Surgeons.

12. Facial Paralysis - Institute For Athletic Medicine Introducing Fairview Rehabilitation Services facial paralysis Clinic specialized rehabilitation for who have facial nerve damage resulting in facial paralysis. Our faces are http://www.athletic-medicine.org/services/facial.shtml

Facial Paralysis Now there’s hope for those who believe their eyes or smile are forever changed by illness, disease or trauma. Introducing Fairview Rehabilitation Services’ Facial Paralysis Clinic: specialized rehabilitation for people who have facial nerve damage resulting in facial paralysis. Our faces are key to nonverbal communication, visually underscoring who we are, what we’re thinking and how we’re reacting to the world around us. Fairly or not, others often judge us by the face we present. The physical and emotional consequences of facial paralysis are significant. Inability to control facial expression interferes with interpersonal communication, impacting individual spirit and confidence. The physical effect interrupts movements and expressions that once came naturally — closing an eye, smiling, talking, eating, drinking. About the Facial Paralysis Clinic Fairview’s Facial Paralysis Clinic is based on retraining neuromuscular and oral-motor techniques that help to diminish paralysis and improve control of the muscles of the face and mouth. Rehabilitation emphasizes control and coordination by improving facial symmetry and strength as well as reducing involuntary facial movements caused by synkinesis, or “cross-wiring,” of the nerves. The program is led by physical therapists and speech-language pathologists who understand the complex facial anatomy, nerves and muscles. Fairview’s Facial Paralysis Clinic is unique in the Twin Cities because it brings together the rehabilitation expertise of speech-language specialists and physical therapists. New scientific evidence suggests electrical stimulation may not produce optimal results, and that traditional therapy methods such as gross facial exercises are ineffective. That’s why this clinic focuses on specific muscular retraining that works to diminish paralysis and improve control of facial movements. Medical staff emphasize education and individualized home programs.

13. Helping Patients With Facial Paralysis: 12/97 Article by Tim Stephens on reconstructive surgery for a patient with facial paralysis. Relevant to the small proportion of people with Bell's palsy who do not regain normal facial movement. http://www.stanford.edu/dept/news/report/news/december3/facial.html

Issue of December 3, 1997 Saving face: Specialized surgery helps patients with facial paralysis BY TIM STEPHENS Gary Torresani grew up with a lopsided face, the result of a facial nerve accidentally severed during an ear operation when he was three months old. Surgeons reattached the cut ends of the nerve during a subsequent operation in 1952, when the boy was five years old, but he never regained full movement on the left side of his face. For most of his life, Torresani simply coped with his impairment, thinking there was nothing more to be done for it. By the mid-1980s, however, the facial paralysis had worsened so much he had a hard time speaking clearly and holding liquids in his mouth. He had also suffered some hearing loss. In 1987, a doctor referred him to Dr. Richard Goode, a professor of surgery (otolaryngology/head and neck) at Stanford who runs a clinic for treating facial nerve injuries. Goode has now operated on Torresani twice ­ first in 1987 and again in 1997 ­ and the improvements both times were dramatic, said Torresani, who lives in Los Gatos. "The operation in 1987 profoundly changed the things I could do," he said. "If I had known about this and had been able to do it even five years earlier, it might have drastically changed my life."

14. Facial Paralysis: Topography Of The Facial Nerve Core Curriculum Syllabus. Syllabusfacial paralysis. 1. nucleus of facial nerve, 2. spinal nucleus of trigeminal nerve. 3. superior http://www.bcm.tmc.edu/oto/studs/fn.html

Core Curriculum Syllabus Syllabus:FACIAL PARALYSIS nucleus of facial nerve spinal nucleus of trigeminal nerve superior sailvary nucleus solitary tract porus acusticus internus meatal foramen greater petrosal nerve sphenopalatine ganglion maxillary nerve lacrimal gland deep petrosal nerve vidian nerve innervation of glands of nose and palate (motor fibers for levator palati muscles) anastamosis with minor petrosal nerve stapedial nerve chorda tympani auricular branch stylomastoid foramen lingual nerve submandibular ganglion submandibular gland sublingual gland Return FACIAL PARALYSIS Return Table of Contents Return to BCOM Otolaryngology Home Page Baylor College of Medicine. Department of Otorhinolaryngology and Communicative Sciences.

15. Sarasmiles.com Canadian surgeon Dr Ronald Zuker performed nerve graft surgery to remedy Sara's leftsided facial paralysis. http://sarasmiles.com

sarasmiles.com;http://members.tripod.com/~sarasmiles8/index.html; sarasmiles.com;http://members.tripod.com/~sarasmiles8/index.html;

16. Medical Encyclopedia: Facial Paralysis (Print Version) Medical Encyclopedia facial paralysis. Definition. facial paralysis is the total loss of voluntary muscle movement of one side of the face. Considerations. http://www.nlm.nih.gov/medlineplus/print/ency/article/003028.htm

To print this page, use the print option from your browser. To close this window, click on the "x" in the upper right hand corner of the window. Medical Encyclopedia: Facial paralysis URL of this page: http://www.nlm.nih.gov/medlineplus/ency/article/003028.htm Alternative names Paralysis of the face Definition Facial paralysis is the total loss of voluntary muscle movement of one side of the face. Considerations Facial paralysis in adults is often due to Bell's palsy. This disorder (probably derived from a virus) usually affects one side of the face causing a drooping mouth, drooling, and excessive tearing from one eye. While the facial distortion usually improves over time, there may be some permanent deformity. Sometimes there is loss of taste on the affected side of the face. Sound may also be louder on the affected side. In facial paralysis due to stroke, the eye on the affected side can be closed and the forehead can be wrinkled. This is not possible with Bell's palsy. Other muscles on one side of the body may also be involved with a stroke. Facial paralysis due to a brain tumor generally develops gradually with accompanying headaches, seizures, or hearing loss.

17. Ãæ̱ | Ãæ̱,ÃæÉñ¾­Âé±Ô,ÃæÉñ¾­Ñ× ÐÂÁÆ·¨ Information about Dr. Zhengqi Lou and details about a Chinese remedy for the cure of facial paralysis. http://www.facesickness.com

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18. What Is Facial Paralysis/Bell's Palsy? - National Centers For Facial Paralysis - Bells Palsy Treastments The National Centers For facial paralysis, Inc. . What is facial paralysis and What are the Causes? Symptoms of facial paralysis. http://www.bellspalsy.com/facialparalysis.htm

What is Facial Paralysis and What are the Causes? Symptoms of Facial Paralysis Recovery and Residual Cases Treatment What is Facial Paralysis and What are the Causes? The most common cause of facial paralysis is Bell's palsy. Bell's palsy is an idiopathic "viral" attack on the facial nerve occurring in approximately 11 persons out of 10,000. The virus most commonly associated with Bell's palsy is the Herpes Simplex-1 Virus (known as HS1). Recent studies show strong clinical evidence that HS1 is the primary cause of previously known idiopathic Bell's palsy. Nearly 80% of all Bell's palsy patients studies were found to have this virus present. Other possible causes of facial paralysis include (but are not limited to): Infection Lyme Disease Neoplastic Acoustic Neuroma ) or other tumors, i.e. parotid glomus jugulare , facial, etc. Trauma Birth Mobius Syndrome Neurologic Gullian-Barre Syndrome Metabolic Toxic Symptoms of Facial Paralysis The paralysis is usually unilateral but is it not uncommon for bilateral involvement. Most paralyses are a once in a lifetime event, however it is not uncommon for patients to experience multiple attacks. Following the first attack, the facial

19. Facial Paralysis Ambulatory Healthcare Pathways for Ear, Nose, and Throat Disorders. Terence M. Davidson, M.D. facial paralysis. facial paralysis Algorithm. Most prescribe steroids. The benefit is controversial. http://www.surgery.ucsd.edu/ent/davidson/pathway/paralsys.htm

20. Partial Facial Paralysis By HD Partial facial paralysis by HD. This article submitted by FT on 3/14/98. Email Address fan_tom@hotmail.com About 12 years ago I http://neuro-www.mgh.harvard.edu/forum/FacialParalysisF/3.14.982.19AMPartialfaci

Partial facial paralysis by HD This article submitted by FT on 3/14/98. Email Address: fan_tom@hotmail.com About 12 years ago I had Tuberculoid Hansen Dicease (leprosy)... the dicease is now cured and I am functioning normally... for the most part. During the course of the dicease, some of my facial nerves were damaged by the leprosy bacilli and the resulting problem is that, the left side of my face looks different from the (normal) right side. I think the problem is getting worse over time (I can tell by looking at my pictures over the years). The most noticeable features of this asymmetry is that my right eye is rounder, the lower eyelid looking drooped, and the edge of my right upper lip is lower. Right now I don't think the problem is a health concern. However it's a big image problem for me. I had consulted with two cosmetic surgeons about options but both had told me that there are no good options from cosmetic surgery. Does anyone here have experience with my condition or one similiar to mine? Can I expect to at least regain a symmetrical face in its relaxed state with some type of surgery/treatment? I would greatly appreciated hearing about your experiences or any info you have. Next Article Previous Article Return to Neurological Disorder Topic Menu Here is a list of responses that have been posted regarding this article...

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