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Cranial Nerves

CN VII: Facial Nerve



    • Roles

    • Special sensory (taste) - anterior ⅔ of tongue
    • Somatic sensory - external ear, posterior auricle (Ramsay-Hunt zone)
    • Somatic motor - facial expression, eye closing
    • Visceral motor (parasympathetic) - submandibular & sublingual salivary glands, lacrimal glands, nasal & palatine glands

Facial Nerve Palsy

    • Abnormalities

    • Facial droop / weakness
    • Inability to close eye
    • Loss of taste
    • Dry eyes / mouth
    • Causes of Facial Nerve Palsy

    • Supranuclear
    • Ischaemic stroke (lacunar or superior cerebellar artery)
    • Tumour - primary / secondary
    • Nuclear / Infranuclear
    • Bell’s palsy (idiopathic)
    • Ramsay-Hunt syndrome (Herpes zoster)
    • Tumour - primary / secondary
    • Parotid gland pathology
    • Otitis media / externa
    • Skull fracture
    • Guillain-Barre
    • Ischaemia
    • Lyme disease
    • Leprosy

Motor Pathway

  • Cortical Centre
    Primary motor cortex (precentral gyrus)
    Facial Motor Nucleus
    Internal auditory meatus
    Geniculate Ganglion
    Temporal, zygomatic, buccal, marginal mandibular and cervical branches
    Facial expression, orbicularis oculi

Special Sensory Pathway

  • Gustatory Cortex
    Facial Sensory Nucleus
    Internal auditory meatus
    Geniculate Ganglion
    Chorda Tympani Nerve
    Sensory and parasympathetic fibres
    Anterior ⅔ of tongue

Parasympathetic Pathway

  • Visceral Nuclei
    Superior salivatory & lacrimal nuclei (pons)
    Tegmentum, red nucleus, medial substantia nigra
    Internal auditory meatus
    Geniculate Ganglion
    Lacrimal glands, salivary glands, nasal & palatine glands
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