The facial nerve

By Dr. Abu Mohammed Alsudani

Introduction
The facial (seventh cranial) nerve is both a motor and sensory nerve.
FUNCTIONAL COMPONENTS:
1. Branchial efferent for facial expression and elevation of hyoid bone.
2. General visceral efferent component is concerned with parasympathetic supply
of the lacrimal gland, submandibular and sublingual salivary glands and the nasal,
palatine and pharyngeal glands.
3. Special visceral afferent for taste sensations from the presulcal area of the
tongue and the palate.
4. General somatic afferent for sensations from the concha of the auricle.
NUCLEI

1. Main motor nucleus: lies deep in the reticular formation of the lower part of the
pons. The part of the nucleus that supplies the muscles of the upper part of
the face receives corticonuclear fibres from both cerebral hemispheres. The
part of the nucleus that supplies the muscles of the lower part of the face
receives corticonuclear fibres from the opposite cerebral hemisphere only.
2. Parasympathetic nuclei: include the superior salivatory and lacrimatory nuclei.
These are situated posterolateral to the main motor nucleus in the column of
general visceral efferent nuclei.
3. Sensory nucleus: is situated in the upper part of the medulla oblongata.
APPLIED ASPECTS
In supranuclear lesions of the facial nerve (usually a part of the hemiplegia),
only the lower part of the contralateral face is paralysed. The upper part (frontalis and
part of orbicularis oculi) escapes due to its bilateral representation in the cerebral
cortex. At this level, cerebrovascular accidents and tumours are the most likely causes.
In infranuclear lesions of the facial nerve, the whole of the face of the ipsilateral side is
paralysed, abolishing both voluntary and emotional movements. The face becomes
asymmetrical and is drawn up to the normal side.
The affected side is motionless. Wrinkles disappear from the forehead. The eye cannot
be closed (lagophthalmos). Any attempt to smile draws the mouth to the normal side.
During mastication, food accumulates between the teeth and the cheek. Articulation of
labialis is impaired.
Facial pulsy management

Immediate refer to neurologist for urgent medical intervention.