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Cranial Nerves

Facial Movement

February 15th, 2021

Facial Weakness

  • How to Elicit

  • Ask the patient to raise their eyebrows, close their eyes, puff out their cheeks and then show their teeth. Apply resistance if the movement appears to be weak.
  • Interpretation

  • Facial weakness without eyebrow droop (central palsy) - suggests an upper motor neuron lesion
  • Facial weakness with eyebrow droop - suggests a facial nerve (VII) lesion
  • Causes of Facial Weakness

  • Upper Motor Neuron Lesion

  • Ischaemia
  • Haemorrhage
  • Tumour
  • Trauma
  • Lower Motor Neuron (Facial Nerve) Lesion

  • Bell's Palsy
  • Herpes Zoster (Ramsay-Hunt syndrome)
  • Tumour
  • Skull Fracture

Extra Credit

  • Muscles of Facial Movement

  • Eyebrow elevation - frontalis, occipitalis
  • Eyebrow depression - procerus
  • Eye closing - orbicularis oculi
  • Puffing cheeks - orbicularis oris, buccinator
  • Showing teeth - platysma, risorius, zygomaticus major & minor, levator labii, levator anguli oris, depressor anguli oris
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