A new lid sign in seventh nerve palsy. 1985

P Arrigg, and D Miller

This paper describes a new lid sign in two patients with facial nerve paralysis. The facial nerve palsy was secondary to a pontine abscess in the first case and a complication of acoustic neuroma resection in the second patient. Both patients were found to have absence of the normal nasal twist of the lower lid during eyelid closure. The nasal twist is felt to help pump tears into the lacrimal drainage system. This paper will describe the absence of an important eyelid function in a patient with facial nerve paralysis. By way of background, Doane's slow motion movies have shown that during a normal blink, the upper lid moves both down and nasally, while the lower lid moves from 2 to 5 mm nasally. As the upper lid descends, the lower lid normally moves 2 to 5 mm in a horizontal and nasal direction. This motion of the lower lid helps produce a partial vacuum in the lacrimal system and is responsible for moving the fluid and debris in the tear mentiscus across the eye and into the lacrimal drainage system. The two cases of facial nerve paralysis to be presented demonstrate absence of tear drainage on the side of the lesion and a build-up and overflow of the tears on that side.

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009464 Neuroma, Acoustic A benign SCHWANNOMA of the eighth cranial nerve (VESTIBULOCOCHLEAR NERVE), mostly arising from the vestibular branch (VESTIBULAR NERVE) during the fifth or sixth decade of life. Clinical manifestations include HEARING LOSS; HEADACHE; VERTIGO; TINNITUS; and FACIAL PAIN. Bilateral acoustic neuromas are associated with NEUROFIBROMATOSIS 2. (From Adams et al., Principles of Neurology, 6th ed, p673) Acoustic Neuroma,Melanocytic Vestibular Schwannoma,Schwannoma, Acoustic,Schwannoma, Vestibular,Acoustic Neuroma, Cerebellopontine Angle,Acoustic Tumor,Angle Tumor,Cerebellopontine Angle Acoustic Neuroma,Cerebellopontine Angle Tumor,Neurilemmoma, Acoustic,Neurilemoma, Acoustic,Neurinoma of the Acoustic Nerve,Neurinoma, Acoustic,Neuroma, Acoustic, Unilateral,Vestibular Schwannoma,Acoustic Neurilemmoma,Acoustic Neurilemmomas,Acoustic Neurilemoma,Acoustic Neurilemomas,Acoustic Neurinoma,Acoustic Neurinomas,Acoustic Neuromas,Acoustic Schwannoma,Acoustic Schwannomas,Acoustic Tumors,Angle Tumor, Cerebellopontine,Angle Tumors,Angle Tumors, Cerebellopontine,Cerebellopontine Angle Tumors,Melanocytic Vestibular Schwannomas,Neurilemmomas, Acoustic,Neurilemomas, Acoustic,Neurinomas, Acoustic,Neuromas, Acoustic,Schwannoma, Melanocytic Vestibular,Schwannomas, Acoustic,Schwannomas, Melanocytic Vestibular,Schwannomas, Vestibular,Tumor, Acoustic,Tumor, Angle,Tumor, Cerebellopontine Angle,Tumors, Acoustic,Tumors, Angle,Tumors, Cerebellopontine Angle,Vestibular Schwannoma, Melanocytic,Vestibular Schwannomas,Vestibular Schwannomas, Melanocytic
D011149 Pons The front part of the hindbrain (RHOMBENCEPHALON) that lies between the MEDULLA and the midbrain (MESENCEPHALON) ventral to the cerebellum. It is composed of two parts, the dorsal and the ventral. The pons serves as a relay station for neural pathways between the CEREBELLUM to the CEREBRUM. Pons Varolii,Ponte,Pons Varolius,Pontes,Varolii, Pons,Varolius, Pons
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D001927 Brain Diseases Pathologic conditions affecting the BRAIN, which is composed of the intracranial components of the CENTRAL NERVOUS SYSTEM. This includes (but is not limited to) the CEREBRAL CORTEX; intracranial white matter; BASAL GANGLIA; THALAMUS; HYPOTHALAMUS; BRAIN STEM; and CEREBELLUM. Intracranial Central Nervous System Disorders,Brain Disorders,CNS Disorders, Intracranial,Central Nervous System Disorders, Intracranial,Central Nervous System Intracranial Disorders,Encephalon Diseases,Encephalopathy,Intracranial CNS Disorders,Brain Disease,Brain Disorder,CNS Disorder, Intracranial,Encephalon Disease,Encephalopathies,Intracranial CNS Disorder
D005143 Eyelids Each of the upper and lower folds of SKIN which cover the EYE when closed. Eyelid
D005158 Facial Paralysis Severe or complete loss of facial muscle motor function. This condition may result from central or peripheral lesions. Damage to CNS motor pathways from the cerebral cortex to the facial nuclei in the pons leads to facial weakness that generally spares the forehead muscles. FACIAL NERVE DISEASES generally results in generalized hemifacial weakness. NEUROMUSCULAR JUNCTION DISEASES and MUSCULAR DISEASES may also cause facial paralysis or paresis. Facial Palsy,Hemifacial Paralysis,Facial Palsy, Lower Motor Neuron,Facial Palsy, Upper Motor Neuron,Facial Paralysis, Central,Facial Paralysis, Peripheral,Facial Paresis,Lower Motor Neuron Facial Palsy,Upper Motor Neuron Facial Palsy,Central Facial Paralyses,Central Facial Paralysis,Facial Palsies,Facial Paralyses, Central,Facial Paralyses, Peripheral,Palsies, Facial,Palsy, Facial,Paralyses, Central Facial,Paralyses, Facial,Paralyses, Hemifacial,Paralysis, Central Facial,Paralysis, Facial,Paralysis, Hemifacial,Paralysis, Peripheral Facial,Pareses, Facial,Paresis, Facial,Peripheral Facial Paralysis
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000038 Abscess Accumulation of purulent material in tissues, organs, or circumscribed spaces, usually associated with signs of infection. Abscesses

Related Publications

P Arrigg, and D Miller
June 1992, Journal of neurology, neurosurgery, and psychiatry,
P Arrigg, and D Miller
October 2010, Journal of the Royal Society of Medicine,
P Arrigg, and D Miller
February 1989, Annals of plastic surgery,
P Arrigg, and D Miller
December 1997, Geriatrics,
P Arrigg, and D Miller
August 1990, Australian and New Zealand journal of ophthalmology,
P Arrigg, and D Miller
July 2002, European journal of pediatrics,
P Arrigg, and D Miller
January 1971, Transactions of the Australian College of Ophthalmologists,
P Arrigg, and D Miller
May 1997, Headache,
P Arrigg, and D Miller
September 2018, Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society,
P Arrigg, and D Miller
January 1989, Indian journal of sexually transmitted diseases,
Copied contents to your clipboard!