Central facial palsy
A facial palsy is weakness or paralysis of the muscles of the face. The facial nerve arises in the pons formed as separate sensory and motor roots , before travelling in the internal acoustic meatus, very close to the inner ear. As they enter the facial canal, the two roots fuse to form a single facial nerve, before giving off intracranial branches of the greater petrosal nerve, nerve to stapedius, and chorda tympani. The facial nerve then exits the facial canal and the cranium via the stylomastoid foramen.
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Background: The distinction between central and peripheral facial nerve palsy can be difficult but is very important for the workup and treatment. A tumefactive demyelinating lesion TDL is a rare condition that can sometimes cause diagnostic difficulties due to its similarity to a brain tumour. Case description: We present a year-old female patient who visited her GP with a discrete right-sided drooping corner of her mouth. The GP started treatment with oral glucorticoids because of presumed Bell's palsy and referred her to the neurology outpatient clinic.
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She complains of no pain or numbness. You perform a neurologic exam; strength and sensation are normal throughout, with no weakness in the arms or legs and no other neurologic findings. Is this a stroke?
Written and peer-reviewed by physicians—but use at your own risk. Read our disclaimer. Facial nerve palsy is a neurological condition in which function of the facial nerve cranial nerve VII is partially or completely lost.