Neoplastic Origins

Fig.2 Image courtesy of the authors

Progression of paralysis beyond 3 weeks suggests a possible neoplastic cause and this is one of the reasons that follow-up is recommended for children presenting with facial nerve paralysis. [2,3,7,8]

The MRI is of a 7-year-old boy with astrocytoma causing facial weakness. Click on the MRI scan to enlarge.

Neoplastic origin in children is suggested by [7,8]:

  • Gradual progression of paralysis beyond 3 weeks [2,3]
  • No return of function after 6/12
  • Ipsilateral recurrence [2,3]
  • Facial hyperkinesia (particularly hemifacial spasm)
  • Associated cranial neuropathies and other neurological signs [2,3]
  • Pain
  • Single branch involvement
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