Neurology Book

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Facial Nerve Paralysis Causes

Aka: Facial Nerve Paralysis Causes, Cranial Nerve 7 Paralysis Causes, Bell's Palsy Differential Diagnosis
  1. See Also
    1. Bell's Palsy
    2. Cranial Nerve 7
  2. Causes: General
    1. Bell's Palsy is idiopathic
    2. Below are listed other causes of Facial Nerve Paralysis
  3. Causes: Common
    1. Peripheral nerve causes (Facial muscle paralysis with forehead affected)
      1. Lyme Disease
      2. Otits Media or Mastoiditis
      3. Ramsay Hunt Syndrome
      4. Autoimmune Polyneuropathy (e.g. Guillain-Barre Syndrome, typically bilateral)
      5. Head or Neck Mass Lesion (e.g. Cholesteatoma)
    2. Central/Supranuclear causes (Facial muscle paralysis with forehead spared)
      1. Cerebral mass lesion (e.g. tumor)
      2. Cerebrovascular Accident (typically with ipsilateral Hemiparesis or Hemiplegia)
      3. Multiple Sclerosis
  4. Causes: Trauma
    1. Cortical injury
    2. Temporal BoneFracture
    3. Brain Stem injury
    4. Penetrating middle ear injury
    5. Barotrauma
      1. Altitude paralysis
      2. Scuba Diving
  5. Causes: Endocrine
    1. Diabetes Mellitus
    2. Hyperthyroidism
    3. Pregnancy
    4. Hypertension
    5. Alcohol Abuse (Alcoholic Neuropathy)
  6. Causes: Infection
    1. Malignant Otitis Externa (skull base Osteomyelitis)
    2. Acute or Chronic Otitis Media
      1. Gradenigo's Syndrome (CN V or CN VI)
    3. Mastoiditis
    4. Varicella Zoster Virus (Chicken Pox)
    5. Herpes Zoster Oticus (Ramsey-Hunt Syndrome)
      1. Herpetic Vesicles at auricle and external canal
    6. Influenza Vaccine and Influenza
    7. Lyme Disease
    8. HIV Infection
    9. Parotitis
    10. Meningitis or Encephalitis
    11. Mumps
    12. Mononucleosis
    13. Leprosy
    14. Coxsackievirus infection
    15. Syphilis
    16. Tuberculosis
    17. Botulism
    18. Mucormycosis
  7. Causes: Tumor
    1. Facial Nerve neuroma
    2. Cholesteatoma
    3. Glomus jugulare tumor
    4. Primary Temporal Bone tumors
    5. Meningiomas
    6. Hemangioblastoma
    7. Hemangioma
    8. Pontine glioma
    9. Parotid tumor
  8. Causes: Birth
    1. See Facial Nerve Injury from Birth Trauma
    2. Trauma (forceps delivery)
    3. Molding
    4. Congenital Facial Palsy
      1. Mobius syndrome
      2. Cardiofacial syndrome
  9. Causes: Toxic
    1. Thalidomide
    2. Tetanus
    3. Diphtheria
    4. Carbon Monoxide
    5. Lead Intoxication
  10. Causes: Idiopathic
    1. Myasthenia Gravis
    2. Guillain-Barre Syndrome
    3. Sarcoidosis
    4. Familial Bell's Palsy
  11. Causes: Iatrogenic
    1. Antitetanus serum
    2. Vaccine treatment for Rabies
    3. Mandibular block anesthesia
    4. Head and neck surgery
  12. References
    1. Zalvan (1999) Consultant 39(1):39-48
    2. Gilden (2004) N Engl J Med 351:1323-31 [PubMed]
    3. Holland (2004) BMJ 329:553-7 [PubMed]
    4. Tiemstra (2007) Am Fam Physician 76:997-1002 [PubMed]

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