Mc Hugh has reported that incidence of neonatal facial nerve Paralysis in 1969, has been 0.23%. Infantile facial nerve paralysis has been categorized to three groups: 1- Congenital (Developmental) facial nerve paralysis2- Prenatal acquired facial nerve paralysis.3- Postnatal acquired facial nerve paralysisThe Mobius syndrome may be the most famous among the causes of congenital facial nerve paralysis. Many suggest the vascular theory for Mobius syrdome. This syndrome has a wide range of clinic pathological signs and symptoms from unilateral facial nerve paralysis to bilateral Facial and Cranial nerve VI paralysis.The involvement of other cranial nerves (IX, X, XII) also has been reported. Few reports suggest the autosomal dominant inheritance of this syndrome and few families presented which several of their members in different generation were disabled with this syndrome. In our research of the literature, we did not found any report about two siblings who are affected by this syndrome. In our cases, family history was negative. Their mother has no history of thalidomide or misoprostol use or rubella during preganacy. The first case is an 18 - year - old male and his right facial nerve is paralyzed. His EMG and NCV show no response in right side. In his temporal bone CT scan, the mastoidian segment of right facial nerve is narrower than contralateral side. The second case is a 16.5 - year - old female and her left facial nerve is paretic. She has been operated for her strabismus when she was 9 - year - old. Her EMG and NCV shows decreased response in left side. In her temporal bone CT scan, the mastoidan segment of left facial nerve is narrower than right side.

Introduction: Idiopathic facial nerve paralysis (Bell,s palsy) have been found as one of the most common form of the cranial nerve palsy. Upon our knowledge, there is not exact cause have been documented by know.currently reactivation of herpes simplex type 1have been suggested in which associated with inflammation, edema, and myelin nerve sheath destraction. To assess the efficacy of anti-inflmmatory (corticosteroids) and antiviral drugs for treating of Bell,s palsy, the present study was designed.Materials and Methods: the prospective study included patients with a diagnosis of Bell,s palsy was referred by neurology and ear, nose, throat outpatient department. Clinical and preclinical examination disclosed lack of intracranial structural lesion. Patients were randomly assigned to two groups to receive either steroids or acyclovir.The severity of facial paralysis was evaluated using the House-Brackmann classification before and after three months of the treatment. Regression to stage 1 or 2 disease was regarded as a successful response. Data were analyzed by the chi-square method and P<.0.05 was takenat-a -significant level. Results: 120 patients were treated by prednisolone (58 cases) and acyclovir (62 cases).Initial evaluation have shown that the severity of facial palsy was identical in both groups (p=0.1431). At the end of three months of treatment the results were statistically different from those of patients receiving acyclovir (p=0.0158). Moreover, the efficacy of acyclovir was more effective on improving the high grade of paralysis .There is no significant response between male or female (p=0.9456).Conclusion: although successful response was found in two treatment regimen ,but response to steroid therapy seemed to be better. Further studies with large patient series and long term follow up are needed to clarify the use of steroids or acyclovir in the treatment of idiopathic facial nerve paralysis.

Introduction: The primary aim of facial reanimation surgery is to restore tone, symmetry, and movement to the paralyzed face. Hypoglossal-facial end-to-side anastomosis provides satisfactory facial reanimation in the irreversible proximal injury of the facial nerve. This study discussed the facial function results of end-to-side anastomosing of hypoglossal nerve to facial nerve when the injury occurred during skull base surgery. Materials and Methods: The present study enrolled a total of 10 patients who underwent end-to-side hypoglossal-facial nerve anastomosis after facial nerve paralysis due to skull base surgery. The data of the patients were gathered from hospital records, pictures, and movies during the 18 months of follow-up. Results: At the 18 months of follow-up, seven (70%) and three (30%) patients were reported with grades III and IV of the House-Brackmann scoring system, respectively. In total, out of the seven grade III patients, six subjects underwent early anastomosis (within the first year of the paralysis). On the other hand, among patients with grade IV, two subjects had late anastomosis. Conclusion: It seems that early end-to-side hypoglossal-facial anastomosis can be a favorable surgical option with good facial function results for reanimating the facial function of patients with facial paralysis following skull base surgery.

Objective: Surgical treatment of facial paralysis: Result assessment of 15 cases referring to Amir-Aalam Hospital. Study design: This prospective study was performed on 16 patients referring to Amir-Aalam Hospital due to facial paralysis during 1377-1380.Etiology of facial paralysis: Was trauma in 12 cases, chronic otitis media in 2 cases, and idiopathic in 2 cases.Patients were evaluated based on the House- Brackman grading system. All of them were suffering from complete facial paralysis (grade VI).Surgery was performed of those who demonstrated either more than 90% fibre degeneration in ENOG within 3 weeks of injury or passing more than 4-6 months since the start of paralysis in the absence of regeneration.Conclusion: Overall 12 decompressions only, 1 decompression and End– to– End anastomosis, 3 decompressions and facial nerve grafting were accomplished.All of them were followed for at least 12 months and at most 36 months.Results were good to satisfactory (I-II/VI) in 12 cases, acceptable (III-IV/VI) in 2 cases and no recovery in 2 cases.

Coronaviruses are important pathogens in humans and animals. Two years ago, a new coronavirus was identified as the cause of pneumonia and adult respiratory distress syndrome. These viruses have many clinical features, and new features are created daily. Bell’, s palsy is sporadic facial nerve palsy. The main reason of Bell’, s palsy is not recognized. Many viruses, such as herpes simplex or herpes zosters, have been previously identified as Bell’, s palsy. This case report seeks to explain the occurrence of Bell’, s palsy in a patient infected with coronavirus. The polymerase chain reaction test of a 60‑, year‑, old woman was positive for SARS‑, CoV‑, 2. Bell’, s palsy happened on the 2 nd day of admission to intensive care unit and recovered by the 12 th day. After ruling out other etiologies of Bell’, s palsy, coronavirus appears to be one of the new etiologies of Bell’, s palsy.

Objectives: Facial Nerve Paralysis (FNP) may cause disfigurement of the face, which result in psychological disturbances and isolation because of society’ s reaction to people’ s physical appearance. This study aimed to determine the relationship between psychological symptoms, age, the severity of symptoms, and societal integration in people with FNP. Methods: The present research is a cross-sectional study involving patients with FNP approved by the research ethics committees of Kano State Ministry of Health and Aminu Kano Teaching Hospital. The instruments used in the study are Hospital Anxiety and Depression Scale (HADS) to assess psychological distress, House-Brackmann Scale (HBS) to assess the severity of facial nerve damage, and the Facial Nerve Palsy Integration Register (FAIR) to assess community integration of patients with FNP. Results: Thirty-seven patients with FNP (16 males and 21 females) with the age range of 14 to 70 years participated in the current study. The findings of this study showed differences in societal integration between males and females (in favor of the males); the severity of FNP decreased as the societal integration of the patients increased, and as age increased, the societal integration decreased. Additionally, there was no difference in the integration between single and married ones. Furthermore, there was a significant positive correlation between depression and societal integration, but no significant correlation existed between anxiety and societal integration of the patients. Similarly, the findings showed a moderate negative significant correlation between the degree of disfigurement (severity) and societal integration of the patients. Discussion: Women and older patients with FNP may have less community integration. However, Women may be less depressed than men since they have social contacts with both men and women.

Purpose: To determine the etiology of oculomotor nerve paralysis over a one year period at a university-based hospital.Methods: This observational case series was conducted on consecutive patients with a clinical diagnosis of isolated oculomotor nerve paresis who were referred to the neuroophthalmology clinic at Farabi Eye Hospital, Tehran, Iran during 2001-2002. All patients were evaluated for hypertension and diabetes. In patients with confirmed diabetes mellitus or hypertension, oculomotor nerve palsy was diagnosed as ischemic. However if no recovery was observed up to four months, the patient underwent MRI and MRA. The etiology of oculomotor nerve palsy was classified into six categories including ischemia, trauma, aneurysm, neoplasm, miscellaneous and idiopathic.Results: During the period of the study, 28 eyes of 28 patients (17 male and 11 female subjects) with mean age of 50.5 years were enrolled. Blepharoptosis was observed in 89.3%. Pupil reaction was normal in 50%, sluggish in 14.3% and absent in 35.7%. Pupil size was normal in 57.1% and mydriatic in 42.9%. The paralysis was ischemic in 42.8%, traumatic in 14.3%, aneurysmal in 7.1%, neoplastic in 7.1%, miscellaneous in 10.7% and idiopathic in 17.8% of the cases.Conclusion: In the present series, ischemia was the most common cause of oculomotor nerve palsy in which the most prevalent underlying disorder was diabetes mellitus.

Purpose: To determine the distribution of oculomotor, abducens, and trochlear nerve palsies in diabetic patients with ocular nerve palsy.Methods: This study was performed on all diabetic patients who referred to ophthalmology and neurology clinics at Yazd Medical Science University because of ocular palsy from March 2004 to October 2005. Signs and symptoms of the disorder were evaluated.Results: Palsies included oculomotorpalsy in 51/2%, trochlear palsy in 24.4%, abducens palsy in 19.5%, and simultaneous palsies in 4.9%. The most common symptoms were diplopia (85.4%), abnormal head posture (63.4%), blurred or disturbed vision (9.8%) and other problems 12.2%). The mostcommonsigns were exotropia (36.6%), hypertropia (24.4%), esotropia (19.5%) and mixed typedeviations (19.5%).Conclusion: The study revealed that more than half of diabetic ocular palsies are due to coulometer palsy and the main symptom in these patients is diplopia.