Neoplastic Origins

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