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 [2,3,8,9].
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 [8,9]:
- 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