FACIAL (SEVENTH CRANIAL) NERVE PALSY

idiopathic:

Bell's palsy (commonest cause)

infections:

Ramsey-Hunt syndrome [herpes zoster of geniculate ganglion]

Lyme disease

leprosy

otitis media

neurological disease:

extensive lateral medullary syndrome (involving seventh nucleus)

acoustic neuroma (late feature)

trauma to nerve:

temporal bone fracture

middle ear surgery

parotid surgery

other / miscellaneous:

sarcoidosis [uveoparotid fever = fever, iritis, parotitis and bilateral seventh nerve palsy]

parotid gland tumour

Guillain-Barre syndrome

neonatal:

trauma during forceps delivery

agenesis of seventh nerve nucleus (Moebius syndrome)

NB: facial palsy (a lower motor neurone lesion) to be differentiated from facial weakness caused by upper motor neurone lesions (eg. cerebrovascular accident) or neuromuscular problems (eg. myotonic dystrophy, myasthenia gravis).

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