Central facial palsy

Damage to the central nervous system motor pathway from the cerebral cortex to the facial nuclei is found in the pons.The motor and parietal areas are reciprocally intertwined and form a group of specialized circuits that work parallel to one another.This pattern of weakness due to the input of the motor neurons of the lower facial muscles is often maintained contralateral.It was found that in many anatomical studies that cortical input from both hemispheres could reach motoneurons that supply muscles of all aspects of the face.[6] Through the combination of anterograde and retrograde tracing techniques in monkeys it was found that the facial nucleus, which supplies muscles of the lower face are innervated bilaterally.[4] Through electrophysiological studies and neuronal tracing, these characteristics do not fully support the typical person with central facial palsy.Often, transcranial magnetic stimulation (TMS) is used to understand the bilateral corticonuclear projections of the lower facial motor neurons.This idea using bilateral innervation to the upper facial motor neurons is rarely tested by humans because of the afferent fibers in the trigeminal nerve are distributed over the head and face and could cause damage.[7] Electromyographical biofeedback or myofeedback could provide patients who have central facial palsy the ability to create myo-electrical potentials that they can interpret.Therefore, by knowing the loop, it allows full or dysfunctional proprioceptive feedback and exteroceptive control of the movement that is necessary in facial muscles.[1] It was found that in normal subjects unilateral TMS stimulation of the motor cortex induced EMG responses from the perioral muscles.This finding supports other studies in favor that bilateral projection of the corticonuclear fibers of the lower facial muscles are present in humans and primates with normal function.[1] This could be because the cortical links and synapses of the upper facial muscles are limited in function and TMS could not presynaptically stimulate the correct areas observed in paralysis.The upper facial muscle ME responses could not be innervated by TMS and the low threshold of blink reflexes often interferes with the nature of corticobulbar influences.
SpecialtyNeurologyparalysisparesisupper motor neuronsfacial nervefacial motor nucleuslower motor neuronscontralateralcorticobulbar tractcerebral cortexipsilateralhemiparesismuscles of facial expressionforeheadstrokelesionsmuscleshemiplegicoropharyngealcentral nervous systemmotor cortexfrontal lobesensoryparietalprefrontal gyrusasymmetrytranscranial magnetic stimulationtrigeminal nervebiofeedbackatrophiedhemiplegiaNeuro developmental treatmentneuropsychologicalhypertonicSpeech therapypronunciationperioralorbicularis oculireflexesExperimental Brain ResearchJournal of Family Medicine and Primary CareCranial nerve diseaseOlfactoryOculomotorOculomotor nerve palsyTrochlearTrochlear nerve palsyTrigeminalTrigeminal neuralgiaAbducensAbducens nerve palsyFacialFacial nerve paralysisBell's palsyVestibulocochlearGlossopharyngealAccessoryAccessory nerve disorderHypoglossalBulbar palsyJugular foramen syndromeCavernous sinus thrombosis