Signs
 

Facial Weakness

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Overview

    • 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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