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Causes of Facial nerve paralysis, aetiology

Here is the aetiology of facial nerve palsy.

I- Supra nuclear causes (Upper Motor Neuron Lesion [UMNL]):

  • Trauma to head.
  • Meningitis, encephalitis, and abscess.
  • Brain tumors.
  • Stroke: Hge, thrombosis, embolism.

II- Peripheral causes (Lower Motor Neuron Lesion [LMNL]):

(A) Intracranial:

1) In pons: Congenital nuclear aplasia, Basal meningitis, Pontine Haemorrage, Pontine tumors, Multiple sclerosis.
2) In CPA: Congenital cholesteatoma, Meningioma, Vestibular schwannoma.

(B) Cranial (intratemporal)

1) Traumatic:
  • Birth trauma: forceps delivery.
  • Fracture especially transverse type.
  • Surgical: mastoidectomy, stapedectomy.
2) Inflammatory:
3) Neoplastic:
4) IdiopathicBell’s palsy 
The commonest cause.

(C) Extra cranial

  1. Trauma: cut wound in parotid or face surgery.
  2. Sarcoidosis of the parotid.
  3. Tumor: malignant parotid tumors

(D) Miscellaneous

  • Polyneuritis (Guillane – Barre Syndrome).
  • Diabetes mellitus.
  • Lyme disease.
  • T.B.
  • Milkersson Rosenthal Syndrome.


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