Sarcoidosis acoustic neuroma causes viith nerve palsy

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Sarcoidosis . Acoustic neuroma causes VIIth Nerve palsy and involve facial Nerve by local compression. 473
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Causes of facial palsy are - (PGI Dec 2000) a) Bell’s palsy b) Herpes infection c) Ramsay Hunt syndrome d) Acoustic neuroma A, B, C, D. 474
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TRUE regarding upper motor neuron Vllth nerve paralysis is - (AIIMS Dec 95) a) Ipsilateral upper face paresis b) Ipisilateral lower face paresis c) Contralateral upper face paresis d) Contralateral lower face paresis 475
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476
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UMN VII C.N. lesion - Contralateral facial muscle paresis that is worse in the lower facial muscles with relative sparing of the upper face. . LMN VII C.N. lesion (Or lesion of nucleus) Unilateral paresis of both upper and lower facial muscles. 477
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Reasoning:- . Facial nerve has a unique feature. All the cranial nerve nuclei of body have unilateral cortical innervation, except facial nerve nuclei The part of facial nerve nuclei supplying the upper half of face has got bilateral cortical innervation (Lower facial muscles have unilateral innervation as all other C.N. nuclei). . So in a unilateral UMN lesion the unner half of face escapes paresis, because of bilateral cortical innervation. 478
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TRUE regarding upper motor neuron Vllth nerve paralysis is - (AIIMS Dec 95) a) Ipsilateral upper face paresis b) Ipisilateral lower face paresis c) Contralateral upper face paresis d) Contralateral lower face paresis D 479
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After a minor head injury a young patient was unable to close his left eye and had drooling of saliva from left angle of mouth. He is suffering from - a) Vllth nerve injury (AlIMSMay 2003) b) Vth nerve injury c) Illrd nerve injury d) Combined Vllth and Illrd nerve injury A 480
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Q ) LMN type Facial palsies - (PGI Dec 02) a) Bell’s palsy most common b) Cornea should be protected c) Bilateral paralysis is seen in Melkerson syndrome d) Unilateral paralysis is seen in Mobius syndrome e) Prognosis affected before repeated electric stimulation 482
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Bell's palsy is the most common form of facial palsy. . It is characterised by: - Abrupt onset. - Feeling of stiffness of face and face pulled to normal side, drooling of saliva present. - Ipsilateral restriction of eye closure due to paralysis of orbicularis occuli. - Difficulty in eating and fine facial movements. - Taste impairement (Palsy of chorda tympani nerve). - Hyperacusis (weakness of stapedius) 483
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Diagnosis of Facial nerve palsy - • Diagnosis is always by exclusion, all other known causes of facial paralysis should be excluded. Nerve excitability tests are done daily or on alternate days and compared with the normal side to monitor nerve degeneration. . The site of the lesion is localized by topodiagnosis, it helps in establishing the etiology and also determining the site of surgical decompression of nerve, if that becomes necessary.
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  • Winter '16
  • jean grey

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