Facial Nerve Paralysis in Children: Difference between revisions
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== Introduction == | == Introduction == | ||
Facial Palsy is one of the most common cranial nerve dysfunctions in children and is a frequent presentation in pediatric emergency facilities. Spontaneous recovery is noted in the majority of the cases and prognosis correlates with age and severity of paralysis. Although less common in children than in adults, facial paralysis can have a huge impact on a child's life as well as the family especially if left untreated.<ref>Wohrer D, Moulding T, Titomanlio L, Lenglart L. [https://www.mdpi.com/2227-9067/9/2/273#B1-children-09-00273 Acute Facial Nerve Palsy in Children: Gold Standard Management.] Children. 2022 Feb 17;9(2):273.</ref><ref>Wang CS, Sakai M, Khurram A, Lee K. [https://www.sciencedirect.com/science/article/pii/S2468548821000370#fig2 Facial nerve palsy in children: a case series and literature review.] Otolaryngology Case Reports. 2021 Sep 1;20:100297.</ref> | [[File:Child facial nerve palsy.jpg|thumb]]Facial Palsy is one of the most common cranial nerve dysfunctions in children and is a frequent presentation in pediatric emergency facilities. Spontaneous recovery is noted in the majority of the cases and prognosis correlates with age and severity of paralysis. Although less common in children than in adults, facial paralysis can have a huge impact on a child's life as well as the family especially if left untreated.<ref>Wohrer D, Moulding T, Titomanlio L, Lenglart L. [https://www.mdpi.com/2227-9067/9/2/273#B1-children-09-00273 Acute Facial Nerve Palsy in Children: Gold Standard Management.] Children. 2022 Feb 17;9(2):273.</ref><ref>Wang CS, Sakai M, Khurram A, Lee K. [https://www.sciencedirect.com/science/article/pii/S2468548821000370#fig2 Facial nerve palsy in children: a case series and literature review.] Otolaryngology Case Reports. 2021 Sep 1;20:100297.</ref> | ||
== Clinically Relevant Anatomy == | == Clinically Relevant Anatomy == | ||
For an in-depth discussion on the facial nerve anatomy, please head to the [[Facial nerve|Facial Nerve]] page. | For an in-depth discussion on the facial nerve anatomy, please head to the [[Facial nerve|Facial Nerve]] page. | ||
The facial nerve, which is the seventh cranial nerve (CNVII), is responsible for facial muscle movement, lacrimation and salivation. Many parts of the head and neck region are innervated by its parasympathetic (secretomotor), motor, and sensory nerve fibers. | |||
The course of the facial nerve is divided into two parts: <ref>Seneviratne SO, Patel BC. [https://www.ncbi.nlm.nih.gov/books/NBK554569/#:~:text=The%20facial%20nerve%20is%20the,The%20main%20motor%20nucleus Facial nerve anatomy and clinical applications.] StatPearls. Treasure Island (FL).</ref> | |||
* intracranial segment | |||
* extracranial segment | |||
The facial nerve divides at the end of the parotid gland into five terminal branches:<ref>Takezawa K, Townsend G, Ghabriel M. [https://pubmed.ncbi.nlm.nih.gov/29243182/ The facial nerve: anatomy and associated disorders for oral health professionals.] Odontology. 2018 Apr;106:103-16.</ref><ref>Myckatyn TM, Mackinnon SE. [https://pubmed.ncbi.nlm.nih.gov/20574465/ A review of facial nerve anatomy.] InSeminars in plastic surgery 2004 Feb (Vol. 18, No. 01, pp. 5-11). Copyright© 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001 USA..</ref> | |||
* temporal - innervates the frontalis and orbicularis oculi muscles and the muscles along with the upper part of the face | |||
* zygomatic - innervates the middle part of the face | |||
* buccal - innervates the cheek muscles | |||
* mandibular - innervates muscles of the lower part of the face | |||
* cervical - innervates the muscles below the chin and platysma muscle | |||
<br> | <br> | ||
Revision as of 21:43, 16 April 2023
This article or area is currently under construction and may only be partially complete. Please come back soon to see the finished work! (16/04/2023)
Original Editor
Top Contributors - Carina Therese Magtibay, Habibu Salisu Badamasi, Chelsea Mclene, Rishika Babburu and Mila Andreew
Top Contributors - Carina Therese Magtibay, Habibu Salisu Badamasi, Chelsea Mclene, Rishika Babburu and Mila Andreew
Introduction[edit | edit source]
Facial Palsy is one of the most common cranial nerve dysfunctions in children and is a frequent presentation in pediatric emergency facilities. Spontaneous recovery is noted in the majority of the cases and prognosis correlates with age and severity of paralysis. Although less common in children than in adults, facial paralysis can have a huge impact on a child's life as well as the family especially if left untreated.[1][2]
Clinically Relevant Anatomy[edit | edit source]
For an in-depth discussion on the facial nerve anatomy, please head to the Facial Nerve page.
The facial nerve, which is the seventh cranial nerve (CNVII), is responsible for facial muscle movement, lacrimation and salivation. Many parts of the head and neck region are innervated by its parasympathetic (secretomotor), motor, and sensory nerve fibers.
The course of the facial nerve is divided into two parts: [3]
- intracranial segment
- extracranial segment
The facial nerve divides at the end of the parotid gland into five terminal branches:[4][5]
- temporal - innervates the frontalis and orbicularis oculi muscles and the muscles along with the upper part of the face
- zygomatic - innervates the middle part of the face
- buccal - innervates the cheek muscles
- mandibular - innervates muscles of the lower part of the face
- cervical - innervates the muscles below the chin and platysma muscle
Mechanism of Injury / Pathological Process
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add text here relating to the mechanism of injury and/or pathology of the condition
Clinical Presentation[edit | edit source]
add text here relating to the clinical presentation of the condition
Diagnostic Procedures[edit | edit source]
add text here relating to diagnostic tests for the condition
Outcome Measures[edit | edit source]
add links to outcome measures here (see Outcome Measures Database)
Management / Interventions
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add text here relating to management approaches to the condition
Differential Diagnosis
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add text here relating to the differential diagnosis of this condition
Resources
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add appropriate resources here
References[edit | edit source]
- ↑ Wohrer D, Moulding T, Titomanlio L, Lenglart L. Acute Facial Nerve Palsy in Children: Gold Standard Management. Children. 2022 Feb 17;9(2):273.
- ↑ Wang CS, Sakai M, Khurram A, Lee K. Facial nerve palsy in children: a case series and literature review. Otolaryngology Case Reports. 2021 Sep 1;20:100297.
- ↑ Seneviratne SO, Patel BC. Facial nerve anatomy and clinical applications. StatPearls. Treasure Island (FL).
- ↑ Takezawa K, Townsend G, Ghabriel M. The facial nerve: anatomy and associated disorders for oral health professionals. Odontology. 2018 Apr;106:103-16.
- ↑ Myckatyn TM, Mackinnon SE. A review of facial nerve anatomy. InSeminars in plastic surgery 2004 Feb (Vol. 18, No. 01, pp. 5-11). Copyright© 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001 USA..
Introduction[edit | edit source]
Causes[edit | edit source]
There are several causes of facial nerve paralysis in children. its can be cause by congenital or acquired.
Congenital[edit | edit source]
This may be due to traumas during birth, as well as hereditary or malformative disorders.
- Delivery trauma: Mother's first child, birth weight larger than 3500 g, use of forceps, cesarean birth, and prematurity are the main known risk factors for traumatic facial paralysis.
- syndromic malformation: can be one of the following:
- Möbius syndrome: It is reported to be due to hypoplasia of the motor nuclei of the cranial nerves within the brainstem, probably due to a hypoxic-ischemic encephalopathy.
- Goldenhar syndrome : Also known as hemifacial microsomia, with a spectrum of congenital malformations involving the structures derived from the first and second branchial arch), can also present a congenital facial paralysis.
- Congenital pseudobulbar palsy (Syringobulbia) : is a condition that clinically manifests with facial paralysis, dysphagia and speech difficulties.
- Arnold-Chiari syndrome: Congenital facial paralysis is usually associated to other cranial nerves paralysis (especially the VI one) due to malformations of the posterior fossa that allow herniation of brain structures through the foramen magnum.
- Hereditary myopathies: such as myotonic dystrophy and myasthenia, are among the genetic causes of facial nerve paralysis. Two loci (chromosome 3q21-22 and 10q21.3-22.1) have also been found to be responsible for isolated hereditary types of facial paralysis.[1]
Acquired[edit | edit source]
Facial paralysis can frequently be due to viral infections.
Herpes Varicella-Zoster may be responsible, even in children, of Ramsay Hunt syndrome (zoster oticus); in this case, facial palsy can be associated to the presence of vesicular lesions of the external auditory canal and/or of the auricular concha. The incidence of this syndrome under 10 years of age is reported to be 2.7/100000.[1]
Not frequently, a bilateral facial nerve palsy may be the onset of a Epstein-Barr virus, Haemophilus influenza, tuberculosis or Borrelia burgdorferi infection.
Lyme disease has become the most common cause of acute facial paralysis in children in those areas where Borrelia Burgdorferi infection is endemic. Other agents that may cause facial nerve palsy in children are cytomegalovirus, adenovirus, rubella, mumps, Mycoplasma pneumoniae and HIV. [1]
