Cranial Nerve VII - Facial Nerve

C
Chhaap
ptter
er cco
onntten
enttss
B
Brraanncchhiiaall m
mo
otto
orr
V
Viisscceerraall m
mo
otto
orr
Special
Sp ecial sen
sensory
sory
G
Gen
ener
eraall ssen
ensso
orryy
PPer
erip
iphher
eraall les
lesion
ionss

Page 13 of 28

Clinical Correlation - Upper Motor Neuron (UMN)

Lesion
Results from damage to neuronal cell bodies in the
cortex or their axons that project via the corticobulbar
tract through the posterior limb of the internal capsule to
the motor nucleus of CN VII.
With an UMN lesion, voluntary control of only the
lower muscles of facial expression on the side
contralateral to the lesion will be lost.
Voluntary control of muscles of the forehead will be
spared due to the bilateral innervation of the portion of
the motor nucleus of CN VII that innervates the upper
muscles of facial expression.
UMN lesions are usually the result of a stroke.

Figure 7-11. Figure 7-11. Clinical correlation - Upper

Motor Neuron (UMN) Lesion. After Wilson-Pauwels, et
al., 1988.

Characteristics of an UMN lesion of the facial nerve

include:
Facial asymmetry
Atrophy of muscles of lower portion of the face
on affected side*
No eyebrow droop*
Intact folds on forehead*

Intact conjunctival reflex (orbicularis oculi

innervation is intact)
Smoothing of nasolabial folds on affected side
Lips cannot be held tightly together or pursed
Difficulty keeping food in mouth while chewing
on affected side
*Distinguishes UMN lesions from LMN lesions.

Last revised: March 22, 1998