HTHSCI 2F03 Lecture Notes - Lecture 15: Ectropion, Uveitis, Optical Coherence Tomography
26 Dec 2020
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Umn signs: sparing of frontalis and orbicularis oculi. Other cn palsies (but seen in 8% of bell"s) May be accompanied by 5th, 6th, and 8th cn palsies. Inflammatory oedema from entrapment of cnvii in narrow facial canal. Failure of eye closure (bell"s sign) dryness and conjunctivitis. 60mg/d po for 5/7 followed by tapering. Valaciclovir if zoster suspected (otherwise antivirals don"t help). Plastic surgery may help if no recovery. With complete lesions, 80% get full recovery but the remainder have delayed recovery or permanent neurological / cosmetic abnormalities. Synkinesis: e. g. blinking causes up-turning of mouth. Crocodile tears: eating stimulates unilateral lacrimation, not salivation. American neurologist james ramsay hunt in 1907. Reactivation of vzv in geniculate ganglion of cnvii. Vesicular rash in auditory canal tm, pinna, tongue, hard palate (no rash = zoster sine herpete) May affect cn7 vertigo, tinnitus, deafness. If dx suspected give valaciclovir and prednisolone w/i first 72h. Otherwise: 1/3 full recovery, 1/3 partial, 1/3 poor.
