Objective This case study is about an 11-year-old girl with bilateral FACIAL weakness, abnormal taste sensation, and absent deep tendon reflexes of both knees and ankles. However, the muscle power of the lower and upper extremities across all muscle groups was normal. After 2 days, she developed paresthesia and numbness in the lower extremities. Other neurologic examinations, such as fundoscopic evaluation of the retina were normal with the muscle power of both upper- and lower-extremities intact. A lumbar puncture revealed albumincytological dissociation. EMG and NCV were in favor of Guillain-Barre syndrome, for which IVIG was prescribed and the abnormal sensations in the lower limbs rapidly improved. Bilateral FACIAL diplegia without weakness and paresthesia is a variant of Guillain-Barre syndrome that mostly presents with acute onset, rapid progression with or without limb weakness, paresthesia, and decreased or absent DTR and albumin-cytological dissociation.

BACKGROUND: Evaluating the function of FACIAL NERVE is essential in order to determine the influences of various treatment methods. The aim of this study was to evaluate and assess the agreement of Photoshop scaling system versus the FACIAL grading system (FGS).METHODS: In this semi-experimental study, thirty subjects with FACIAL NERVE paralysis were recruited. The evaluation of all patients before and after the treatment was performed by FGS and Photoshop measurements.RESULTS: The mean values of FGS before and after the treatment were 35±25 and 67±24, respectively (p<0.001). In Photoshop assessment, mean changes of face expressions in the impaired side relative to the normal side in rest position and three main movements of the face were 3.4±0.55 and 4.04±0.49 millimeter before and after the treatment, respectively (p<0.001). Spearman's correlation coefficient between different values in the two methods was 0.66 (p<0.001).CONCLUSIONS: Evaluating the FACIAL NERVE PALSY using Photoshop was more objective than using FGS. Therefore, it may be recommended to use this method instead.

Introduction: One of the most prevalent childhood vasculitis is kawasaki disease (KD), which mainly affects medium-sized arteries throughout the body. This disease usually does not cause many neurological symptoms and only rarely results in FACIAL NERVE PALSY (FNP).Case presentation: A 4.6-month-old iranian girl presented due to a prolonged fever. Lab tests showed increased CRP, ESR, ferritin, WBC, and platelet counts, and echocardiography revealed dilated right and left main coronary arteries, without any vegetations, pericardial effusion, and atrioventricular valve regurgitation. The patient was diagnosed with incomplete KD. At the same time, she developed left-sided peripheral FNP. Patient treated with intravenous immunoglobulin and aspirin. The fever resolved after about 36 hours, and the patient was discharged on the 16th day of hospital admission. Follow-up echocardiography demonstrated gradually resolution of her coronary arteries dilation. FNP was recovered completely after about 2 months.Conclusion: FNP is an uncommon neurological symptom of KD. However, it typically resolves on its own and without any lasting effects in those who survive the illness. Nevertheless, it may indicate a higher likelihood of coronary artery involvement, and as a result, additional anti-inflammatory treatments and more closely monitored echocardiography may be necessary.

Introduction: Generally, glomus tumors are considered tumors of the autonomic system arising from chromaffin cells of the parasympathetic paraganglia of the skull base and neck. Glomus tympanicum is the most common primary tumor of the middle ear cavity and it arises from the paraganglia of the middle ear. Case Report: We present a case of glomus tympanicum presented in a 70-year-old woman, complicated with FACIAL NERVE PALSY which at first sight was misdiagnosed as cholesteatoma. Patient presented in our clinic because of otorrhea, pulsatile tinnitus and hearing loss in the right ear. However, FACIAL NERVE function was good in the first examination (40 days before the surgery). Eventually, she treated successfully with a canal wall down mastoidectomy. Technique had been chosen because of the mass size and the involvement of external auditory canal, after a discussion with the patient. Conclusions: Although histologically benign, glomus tympanicum is slow growing and destructs adjacent tissues potentially. The two most common complaints are hearing loss (conductive) and pulsatile tinnitus. These neoplasms are more common in women and they can be diagnosed by CT or MRI scan. It is of high importance physicians suspect a glomus tumor when patient ‘, s clinical findings are hearing loss and pulsatile tinnitus and use an intravascular agent in imaging so that the differential diagnosis will be supported.

Objective: Synkinesia is a sequel of FACIAL NERVE PALSY. It usually begins 3-4 months after axonal regeneration and progresses up to two years afterward. Treatment of synkinesia is very difficult and sometimes impossible. The aim of our study is find a better procedure to treat FACIAL NERVE PALSY and prevent synkinesia.Materials & Methods: Twenty nine patients with FACIAL NERVE PALSY were selected by electrodiagnostic tests. They were divided in two groups. The experimental group was treated by biofeedback electromyography and the second group was treated by common physiotherapy. The evaluation of all patients was done by Photoshop assessment and FACIAL grading scale, before and after treatment.Result: After the treatment, a significant general improvement was observed in both groups (P<0.05), but experimental group (biofeedback) showed better result than the other one. The number of patients with synkinesia as well as the severity of their synkinesis in experimental group were decreased milder than the other one.Conclusion: Biofeedback therapy is more efficient than common physiotherapy. By using this approach, control and reducing synkinesia is more feasible. Assessment by Photoshop procedure showed better accuracy than FACIAL grading scale.

Introduction:The important sequelae of FACIAL NERVE PALSY are synkinesis, asymmetry, hypertension and contracture; all of which have psychosocial effects on patients. Synkinesis due to mal regeneration causes involuntary movements during a voluntary movement. Previous studies have advocated treatment using physiotherapy modalities alone or with exercise therapy, but no consensus exists on the optimal approach. Thus, this review summarizes clinical controlled studies in the management of synkinesis and asymmetry in FACIAL NERVE PALSY.Materials and Methods:Case-controlled clinical studies of patients at the acute stage of injury were selected for this review article. Data were obtained from English-language databases from 1980 until mid-2013.Results:Among 124 articles initially captured, six randomized controlled trials involving 269 patients were identified with appropriate inclusion criteria. The results of all these studies emphasized the benefit of exercise therapy. Four studies considered electromyogram (EMG) biofeedback to be effective through neuromuscular re-education.Conclusion:Synkinesis and inconsistency of FACIAL muscles could be treated with educational exercise therapy. EMG biofeedback is a suitable tool for this exercise therapy.

FACIAL NERVE PALSY affects individuals of all ages, races, and sexes. Psychological and functional implications of the paralysis present a devastating management problem to those afflicted. FACIAL paralysis following trauma, surgery or due to idiopathic (unknown), eye health at risk.The most devastating sequelae of FACIAL NERVE paralysis is the loss of eyelid function. The inability to blink and protect the globe can lead to exposure keratitis, corneal abrasion and even the loss of vision. For this reason, treatment of eye complications for FACIAL paralysis is of major importance.Various methods such as medical treatments (botulinum toxin) or surgical (internal or external weights on the upper eyelid or tarsorraphy) are used. So careful planning and long-term it is necessary to revive the eyelids and face. In this study reviews the various eye problems and the way we treat it.

Mucormycosis is an expeditious invasion of a fungus of angioinvasive nature, predominant in immunocompromised individuals, often leading to organ malfunction and loss. FACIAL NERVE involvement and total ophthalmoplegia are its rare presentations. Early detection and treatment can alter natural disease course and prevent potential catastrophic outcomes in diabetic patients. FACIAL NERVE PALSY is mostly attributed to peripheral neuropathy in patients with advanced diabetes mellitus. It rarely raises alarm about an invasive fungal infection. Here, we report the case of a 38-year-old male with type 2 diabetes mellitus, who presented to us with left lower motor neuron type FACIAL PALSY and left-sided total ophthalmoplegia due to invasive rhino-orbito-cerebral mucormycosis (ROCM). Despite aggressive measures, including antifungal therapy and repeated endoscopic debridement, he subsequently developed central retinal artery occlusion (CRAO) and underwent left eye exenteration.

When a child presents with cranial NERVE PALSY and a bulging fontanel, a pediatric neurologist is often consulted to determine the cause of increased intracranial pressure. This report describes an infant with chronic myelogenous leukemia (CML) referred to Ali-bin-Abitaleb Hospital, Zahedan, eastern Iran in 2013 who presented with seventh cranial NERVE PALSY and bulging fontanel. Chromosomal analysis and peripheral blood smear confirmed the diagnosis of CML.