FACIAL NERVE DISORDERS

Facial weakness is caused by both central and peripheral lesions, and differentiating between the two frequently requires close examination. Peripheral facial weakness involves both the upper and lower part of the face to the same degree, whereas upper motor neuron lesions typically manifest with a gradient of weakness, with relative preservation of movement in the brow and forehead (e.g., frontalis muscles). Supranuclear lesions, such as in suprabulbar palsies, may result in an absence of voluntary facial movements but retention of reflexive movements (e.g., smiling) in response to emotional stimuli.

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