Left lower motor neuron facial weakness

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Neurological examination showed a left lower motor neuron facial weakness and left periocular fasciculations. His fundi and visual fields were normal. There was decreased sensation to pin prick in the distribution of left infra-orbital branch of the trigeminal nerve. The motor branch of the trigeminal was intact. Corneal sensation was intact.

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Lesions that damage the motor cortex, such as acute ischemic strokes, will result in contralateral facial weakness of the lower face only, with preservation of the muscles of the upper face on.


The face is always weak on the same side as the arm and leg if it is an upper motor neurone facial weakness. This means that it is not really necessary to talk about "a patient with a right hemiparesis and right facial upper motor neurone weakness" this is saying the same thing twice. Damage to the facial nerve - either upper motor neurone (UMN) or lower motor neurone (LMN) - produces weak muscles of facial expression. The VIIth cranial (facial) nerve is largely motor in function (some sensory fibres from external acoustic meatus, fibres controlling salivation and taste fibres.
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A lower motor neuron lesion of the face equally involves muscles of the upper and lower face. An upper motor neuron lesion (supranuclear corticospinal lesion) is characterized by decreased voluntary movement of the lower face with flattening of the nasolabial angle on the ipsilateral side of the face.

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Therefore, upper motor neuron lesions, such as a stroke, cause contralateral face weakness sparing the forehead, while lower motor neuron lesions, such as a facial nerve injury, typically cause weakness involving the whole ipsilateral face. Dec 08, · An otolaryngological examination was unremarkable but for incomplete left lower motor neuron type of facial palsy (House & Brackman Grade III). A provisional diagnosis of Idiopathic Facial Paralysis (Bell's Palsy) was made and the patient was discharged home after reassurance and on no specific medications.

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