Facial Nerve Palsy: Or something else? Differential Diagnosis

Cardiovascular (I00-I99).

  • Apoplexy – Lesion of contralateral cortex or corticobulbar tracts after ischemic infarction.

Psyche – nervous system (F00-F99; G00-G99).

  • Frey’s syndrome (auriculotemporal syndrome) – usually triggered by irritation of the auriculotemporal nerve, reddening of the skin and increased sweating in the ear-sleep region.
  • Hemispasm facialis – involuntary contractions of the facial mimic muscles (facial muscles) affecting only one side of the face.
  • Hemifacial myokymia – wave-like appearing movement of the mimic musculature (facial musculature), which affect one half of the face.
  • Hunt’s neuralgiapain in the area supplied by the facial nerve, as well as facial nerve paresis in the context of zoster oticus (form of herpes zoster (shingles) affecting the ear).
  • Melkersson-Rosenthal syndrome – idiopathic inflammatory disease associated with lip swelling and peripheral facial nerve palsy.
  • Multiple sclerosis (MS)
  • Sluder’s neuralgiapain caused by inflammation of the pterygopalatine ganglion.
  • Tic disorders – repeated occurrence of involuntary contractions of individual muscles or muscle groups.

Neoplasms – tumor diseases (C00-D48).

  • Acoustic neuroma (AKN) – benign tumor arising from Schwann’s cells of the vestibular portion of the VIII. Cranial Nerve, the auditory and vestibular nerves (vestibulocochlear nerve), and is located in the cerebellopontine angle or internal auditory canal. Acoustic neuroma is the most common cerebellopontine angle tumor. More than 95% of all AKNs are unilateral. In contrast, in the presence of neurofibromatosis type 2, acoustic neuroma typically occurs bilaterally.
  • Malignant parotid tumors – neoplasms of the parotid gland.
  • Meningiomas, glomus tumor – originating from the cerebellopontine angle, often further cranial nerve failures.
  • Tumors (neoplasms) at the base of the skull, brainstem or cerebellopontine angle.