Bilateral facial nerve paralysis in a dog

Re: Bilateral facial nerve paralysis in a dog

Michael Woodhouse — Tue, 24 Dec 2013 00:26:28 GMT

Pituitary tumours have been described in the literature of compressing the CN VII root and causing facial numbness, in humans.

One of those real zebra diagnoses, but you already have Cushings........

Is the dog insured? Can we scan its brain? Please.

Re: Bilateral facial nerve paralysis in a dog

Yantha Smyth — Mon, 23 Dec 2013 21:36:22 GMT

Thanks Laurent, that is very helpful. I rechecked her today, and her eyes have stayed moist and comfortable. She appears to have very good third eyelid and retractor compensation for the lack of blink which is probably helping to protect the corneas. STT L eye 25 R eye 20. Still cannot find deficits of other nerves. We are planning to monitor and maintain with lubrication prophylactically, and hope for some spontaneous recovery. Thanks again Yantha

Re: Bilateral facial nerve paralysis in a dog

Laurent Garosi — Mon, 23 Dec 2013 11:57:01 GMT

Dear Yantha,

The bilateral facial paralysis would suggest bilateral involvement of CN VII. In the absence of other signs, I would expect bilateral peripheral nerve disease as opposed to brainstem disease. Differential diagnosis would include in order of likelyhood 1) bilateral idiopathic facial nerve paralysis, 2) bilateral middle ear disease, 3) inflammatory/idiopathic/paraneoplastic polyneuropathy. I would expect other motor cranial nerve involvement and possibly limb signs (abnormal gait, abnormal segmental spinal reflexes) for the latter. Link with current medication is extremely unlikely. With idiopathic facial nerve paralysis, recovery may take weeks and not all dogs may recover full blink reflex. I would suggest checking tear production with Schirmer tear test in case of concurrent involvement of parasympatheic supply of the lacrimal gland causing KCS.

Hope this help?

Laurent