Presentation
If the child presents soon after onset, suppression of the non-dominant eye has usually not been present long enough to produce suppression amblyopia, but a difference in visual acuity may be present later on. [reviewofophthalmology.com]
Patients with facial nerve paralysis resulting from tumours usually present with a progressive, twitching paralysis, other neurological signs, or a recurrent Bell's palsy-type presentation. [en.wikipedia.org]
Here we present a rare case of isolated posterior fossa involvement presenting clinically as congenital facial palsy. [file.scirp.org]
Its is important to consider this condition in children presenting with unusually exaggerated facial asymmetry as some cases may be associated with dysfunction of eighth cranial nerve. [neurology.org]
High-resolution imaging showed both facial nerves to be present but symmetrically and markedly hypoplastic with no other structural abnormality in the brainstem. [ncbi.nlm.nih.gov]
Entire Body System
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Falling
[…] brain that occurs at or shortly after birth) metabolic disorder (a disorder that interferes with the body's ability to maintain itself) Damage to the spinal cord is most often caused by trauma, such as a fall or a car crash. [medical-dictionary.thefreedictionary.com]
Diseases combined with synergistic divergence fall within the category of congenital cranial dysinnervation disorders (CCDDs)... [readbyqxmd.com]
The functional impairment of facial movements appears to be caused by a nuclear or peripheral site of lesion without brainstem interneuronal involvement. [17] Hemifacial microsomia Several subcategories exist that fall under the spectrum of oculo-auriculo-vertebral [emedicine.medscape.com]
The injury however may fall anywhere along the spectrum described by Sunderland from first degree to fifth degree (Sunderland, 1978). Recovery will depend upon the degree of injury. [sydneyfacialnerve.com]
[…] disorders: Differential Diagnosis Unilateral VII weakness Idiopathic: Bell's palsy Sarcoid & other granulomatous disorders Infection Leprosy : Especially with paralysis of upper face Otitis media Lyme disease Epidemiology: European, Children, Summer & Fall [neuromuscular.wustl.edu]
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Myxedema
True False Myxedema, or severe hypothyroidism, has its onset during infancy. True False Oral hypoglycemic agents such as DiaBeta and Glucophage can cause symptoms similar to diabetic coma. [quizlet.com]
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Pallor
The symptoms and signs of anemia include a. pallor, weakness, fatigability, and listlessness. b. an abnormal reduction of red blood cells. c. tachycardia, jaundice, and mental sluggishness. d. all of the above. [quizlet.com]
Skin
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Alopecia
RES may occur in isolation or be part of the Gómez‐López‐Hernández syndrome, which is characterized by RES, parietal alopecia, trigeminal anesthesia, and craniofacial dysmorphic signs [ 14 ]. [cerebellumandataxias.biomedcentral.com]
Musculoskeletal
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Acrocephaly
[…] micrognathia-glossoptosis Q87.0 oral-facial-digital Q87.0 oro-facial-digital Q87.0 oto-palatal-digital Q87.0 whistling face Q87.0 Tower skull Q75.0 ICD-10-CM Diagnosis Code Q75.0 Craniosynostosis 2016 2017 2018 2019 Billable/Specific Code POA Exempt Applicable To Acrocephaly [icd10data.com]
Neurologic
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Dysarthria
Flaccid dysarthria results from the facial muscle paralysis. [emedicine.medscape.com]
Inability to abduct past midline Patterns Bilateral: 90% Abducens nerve palsy, isolated: 9% Conjugate horizontal gaze paresis: 48% Duane retraction syndrome : 34% Congenital fibrosis of extraocular muscles : 9% Bulbar Palate and pharynx dysfunction: 56% Dysarthria [163.178.103.176]
The adult and childhood phenotype is characterized by visual loss due to retinitis pigmentosa, progressive ataxia, dysmetria, intention tremor, dysarthria, dysphagia, and brisk reflexes. [cerebellumandataxias.biomedcentral.com]
With liver failure dementia, confusion, aphasia, dysarthria, tremors of the limbs, and coma may result. Kidney failure is often associated with high blood pressure, which may lead to acute brain edema (distension with fluid), visual loss, and coma. [britannica.com]
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Nystagmus
Full examination focusing on eye movement (nystagmus) the trigeminal nerve, and all lower cranial nerves is important. Where relevant, tests of balance, co-ordination and gait should be included. [sydneyfacialnerve.com]
A small, firm, nonmobile, painless, subcutaneous nodule on the margin or body of the eyelid describes a. a hordeolum (stye). b. strabismus. c. nystagmus. d. a chalazion. [quizlet.com]
PMD may present during the neonatal period (connatal PMD) with hypotonia, inspiratory stridor, horizontal or rotatory nystagmus, and seizures. [cerebellumandataxias.biomedcentral.com]
The primary signs of cerebellar disease are nystagmus, ataxia, and scanning speech. ( See Unlocalized or multifocal disorders: Demyelinating diseases .) [britannica.com]
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Papilledema
A complete neurologic examination should follow, evaluating for papilledema as well as any other neurologic abnormalities. [reviewofophthalmology.com]
This swelling, called papilledema, is caused by raised pressure within the skull. [britannica.com]
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Dizziness
Patients with Ramsay Hunt syndrome develop painful lesions on the ear, facial paralysis, hearing loss, and dizziness. Our specialists treat Ramsay Hunt syndrome with a combination of steroids and antiviral medications. [masseyeandear.org]
Other cranial nerve symptoms including subjective facial sensory disturbance, tinnitus, dizziness, dysacusis, vertigo, dysgeusia and tearing abnormalities should be sought (Adour, 1978). [sydneyfacialnerve.com]
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Myoclonic Jerking
Central nervous system toxicity results and infants typically present in the first 2 days of life with depressed alertness, hypotonia, myoclonic jerks, and refractory seizures. Many progress quickly to apnea, coma, and death [ 37 ]. [cerebellumandataxias.biomedcentral.com]
Subacute necrotizing encephalopathy, also called Leigh disease, is a lethal disorder of infancy marked by psychomotor delay, myoclonic jerks, paralyses of eye movements, and respiratory disorders. [britannica.com]
Treatment
Treatment of idiopathic facial nerve palsy/Bell palsy: -Steroids. [clinicaladvisor.com]
May be treated with botulinum Probably due to misregeneration of nerve Face weakness: 30% Contracture: 20% Crocodile tears: 6% Blepharospasm: May occur years after paralysis Treatment of Bell's palsy Statistical degrees of benefit from drug treatment [163.178.103.176]
CLOSE Medical Disclaimer The medical information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. [diseaseinfosearch.org]
[…] of Bell's palsy Statistical degrees of benefit from drug treatment Prednisone Placebo More benefit when treatment started within 3 days of onset No benefit from treatment starting more than 10 days after onset Corticosteroids Use within one week of onset [neuromuscular.wustl.edu]
Comparison of normals, physical examination, history, treatment plan, prognosis b. Medical history, physical examination, diagnostic tests, diagnosis, integration of results, treatment c. [quizlet.com]
Prognosis
However, in a majority of the cases, the facial nerve palsy resolves on its own, without therapy; although, close clinical monitoring is initially necessary The prognosis of Facial Nerve Palsy due to Birth Trauma is usually excellent with treatment Who [dovemed.com]
The prognosis for good recovery is better in cases when the paresis is only partial. Facial nerve palsy has a broad differential diagnosis. [clinicaladvisor.com]
The aim of the study was to investigate the clinical presentation and prognosis of recurrent facial nerve palsy (RFNP) in children. [link.springer.com]
Lacrimation: Mildly affected in some patients Taste: No clinically significant changes in most patients Sensory loss 7 Mild or None May be present on face or tongue: On side of paralysis Possibly related to involvement of greater superficial petrosal nerve Prognosis [163.178.103.176]
[…] titers Electrodiagnositic testing: In severe paresis to determine extent of injury Variant: Bilateral simultaneous facial palsy 12 Frequency: 0.4% of Bells palsy Onset in 2nd nerve: 1 to 6 days after 1st nerve paresis Severity: Often severe bilaterally Prognosis [neuromuscular.wustl.edu]
Etiology
This is followed by trauma, elevated intracranial pressure, inflammatory causes and post-viral etiologies. 1,2,7-9 - Intracranial neoplasm. [reviewofophthalmology.com]
The hypothesis that HSV-1 is the etiologic agent in Bell's palsy was proposed in 1972 by McCormick. [news-medical.net]
Noah Möbius and Möbius-like patients: etiology, diagnosis and treatment options Clin Plast Surg, 29 (2002), pp. 497-514 [11] H.T. Verzijl, B. van der Zwagg, M. [analesdepediatria.org]
If there is an infectious etiology of facial nerve palsy (OM, HSV, VZV, Lyme), treat with antibiotics or antiviral therapy directed against the underlying cause. [clinicaladvisor.com]
(Etiology) The exact cause of ‘Facial Nerve Palsy due to Birth Trauma’, during childbirth is unknown The use of forceps in a delivery could result in the condition, as a side effect. [dovemed.com]
Epidemiology
Congenital Facial Paralysis 59 Moebius Syndrome 2, Formerly; Mbs2, Formerly 57 Facial Paresis, Hereditary, Congenital Hcfp1 73 Hereditary Congenital Facial Paresis 1 29 Moebius Syndrome 2, Formerly 57 Mobius Syndrome 2, Formerly 57 Mbs2, Formerly 57 Orphanet epidemiological [malacards.org]
Classification (Orphanet): - Rare developmental defect during embryogenesis - Rare genetic disease - Rare maxillo-facial surgical disease - Rare neurologic disease Classification (ICD10): - Congenital malformations, deformations and chromosomal abnormalities - Epidemiological [csbg.cnb.csic.es]
[…] tightly together: Difficulty keeping food in mouth Facial muscle atrophy (Late) Electrophysiology EMG Denervation Synkinesis: Late Blink reflex Abnormal ipsilateral R1 (early, disynaptic) R2 (late multisynaptic) responses Synkinesis (Late) Bell's Palsy 8 Epidemiology [neuromuscular.wustl.edu]
[…] droop Loss of forehead &d nasolabial folds 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 8 Epidemiology [163.178.103.176]
Pathophysiology
Bell's palsy is considered an idiopathic condition, which means the cause of the inflammation is not known and the exact pathophysiology remains uncertain. [news-medical.net]
Pathophysiology Main cause of Bell's palsy is latent herpes viruses (herpes simplex virus type 1 and herpes zoster virus), which are reactivated from cranial nerve ganglia Edema of nerve within inelastic fallopian canal Recovery begins by 3 weeks [slideshare.net]
Prevention
Prevention of Birth Defects In the past ten years, there have been significant strides in understanding ways to prevent some birth defects. [encyclopedia.com]
Childhood immunizations are important because a. they are needed to obtain a passport. b. they help prevent colds. c. they prevent epidemics of serious contagious diseases. d. all of the above are true. c. they prevent epidemics of serious contagious [quizlet.com]
Prevention Prevention of paralysis depends on prevention of the underlying causes. Risk of stroke can be reduced by controlling high blood pressure and cholesterol levels. [medical-dictionary.thefreedictionary.com]
In younger patients, patching may be necessary to prevent or treat amblyopia. If a compensatory head posture allowing binocular fusion is present, patching may be optional unless there is a change in visual acuity or angle of deviation. [reviewofophthalmology.com]