Central and Peripheral Nerve Paralysis

Table 2: Clinical aspects of facial nerve paralysis

Facial nerve paralysis
Central	Upper motor neurone implies a cause other than Bell’s palsy
Peripheral	Lower motor neurone [7]

The assessment of the child with facial nerve paralysis requires a full and thorough head to toe examination to ensure important clues to possible causes are not missed. [9]

It is important to distinguish between the following types of facial nerve paralysis (Table 2):

• Central facial nerve paralysis
• Peripheral facial nerve paralysis

Neurological examination should include:

• Cranial nerves and peripheral nervous system
• Testing of VIIn should reveal a lower motor neurone (LMN) pattern with inability to wrinkle the forehead. Preservation suggests a central cause