Daily Bolus: 7th nerve palsy

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February 7, 2011 by dailybolusoflr

The classic distinguishing feature between a peripheral 7th cranial nerve (facial nerve) palsy and a central 7th cranial nerve palsy is the involvement of the upper face (forehead). 
Peripheral lesions involve the entire unilateral face and lead to complete facial nerve weakness. 
Central lesions spare the forehead while affecting the lower face. 
Commonly accepted treatments for peripheral 7th nerve palsy (commonly referred to as Bells palsy when there is no clearly identifiable cause such as trauma, tumor etc) include:
·         Steroids (if started within 72 hours) for 5-14 days
·         Anti-viral medications such as acyclovir have become more controversial and may or may not offer benefit
·         Artificial tears during the day and lacrilube at night +/- taping the eye shut while sleeping.  Protection of the cornea is of utmost importance when there is motor dysfunction of the eyelid or ability to adequately lubricate. 
Happy Friday!!

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