Ansiktsparese

Ansiktsparese, known in English as facial paresis or facial nerve palsy, is a weakness or paralysis of the facial muscles on one side of the face caused by dysfunction of the facial nerve (cranial nerve VII) or its central pathways. The condition can be classified as peripheral or central.

Peripheral facial paresis is the more common form and includes Bell's palsy (often idiopathic), as well as pareses due to infections such as herpes simplex or varicella-zoster, trauma, surgery, and tumors affecting the facial nerve. Central facial paresis arises from lesions in the brain's motor pathways, such as stroke or demyelinating diseases. In central cases, the forehead is often partially able to move because of bilateral innervation.

Symptoms typically include drooping of the mouth corner, inability to close the eye on the affected side, reduced blinking, drooling, and difficulty with facial expressions. Some patients report changes in taste on the front part of the tongue or increased sensitivity to sound (hyperacusis). Distinguishing peripheral from central causes relies on pattern of weakness, especially whether the forehead shows movement.

Diagnosis is primarily clinical, based on history and examination. Imaging such as MRI or CT may be used when a central cause or other intracranial pathology is suspected. Additional tests may be guided by suspected etiologies, including infectious or inflammatory workups, and facial nerve electrophysiology in selected cases.

Treatment depends on the underlying cause. Bells palsy is commonly treated with short courses of corticosteroids, sometimes with antivirals. Eye protection and lubricating drops are important for incomplete eye closure. Physiotherapy and, in some cases, botulinum toxin for synkinesis may be used. Most people recover completely within weeks to months, especially with timely treatment; persistent symptoms may occur in some cases.