Facial nerve paralysis - Clinical

If there is a complete sectioning of the facial nerve in the hole stilomastoidiene appears all the muscles of facial paralysis.
 The patient shows left corner of the mouth of the affected facial skin folds are removed, it folds and loose skin on the forehead and eyelids can not close. In an attempt to close the eyelids of the affected patient's eye rotates upwards and outwards (sign Bell).Lacrimal point becomes more obvious and no longer drains tears lacrimonasal channel, but flow on the cheek. Chewing not be done properly, and saliva dripping from the corners of the mouth. Taste does not seem to be interested.
 If the lesion is in the middle ear, the taste is lost in the previous two-thirds of the tongue lesion.If that innervating the affected muscle and ram footpeg then no longer accommodate the loud sounds and realized there is a painful sensitivity to noise.If injuries occur in the internal auditory meatus can develop deafness, tinnitus (ringing in the ears) or vertigo. In intrapontine lesions, usually near the affected nucleus VII nerve tracts are affected and sensitive corticospinale and abducens nerve and nucleus.
 The neurological examination of reflexes is found disorders:- Reflex opticopalpebral - eyelid closure from exposure to sunlight - the missing paralyzed.- Reflex nazopalpebral - bilateral closing of eyelids to the nose root percussion - is currently the only unaffected.- Cohleopalpebral reflex - reflex eyelid closure in the presence of a strong sound exciting - there's the part affected.- Corneal reflex - closing the lid to reach the cornea with a piece of cotton - is abolished by the sick.
 If facial nerve paralysis was not treated in time the body tries TROUBLE motor function recovery. Narrow slit eyelids, nasolabial fold deepens, there is a diffuse contraction of facial muscles.Healthy parts of the face trying to compensate for motor deficit on the affected side, but in a wrong manner. The nose is pulled from healthier. Trying to raise a group of facial muscles translates into all muscle contraction. Can facial muscle spasms occur.
 If regeneration is absurd thread, there are other disturbing phenomena. For example, if the fibers innervating orbicularis eyelid orbicularis muscle connects with the lips, then attempts to close the eyelids produces a contraction of perioral edge. If fibers innervating facial muscles gland connects to tears, then there is a phenomenon called "crocodile tears" - the patient weep during the meal.
 The differential diagnosis is made: tumor invading the temporal bone (colesteatoame, dermoid tumors), Ramasy-Hunt syndrome, neurinomul acoustic poliradiculonevrita acute inflammatory (Guillain-Barre syndrome), fever uveoparotidiana (Heerfordt syndrome), Lyme disease, Melkersson-Rosenthal syndrome , hemiatrofia Romberg's facial, facial miokimia, blepharospasm.