E1769. Facial Drooping and No Frowning: Multimodality Imaging in Facial Nerve Palsy
  1. Shivaprakash Hiremath; The Ottawa Hospital
  2. Carlos Torres; The Ottawa Hospital
  3. Rafael Glikstein; The Ottawa Hospital
  4. Santanu Chakraborty; The Ottawa Hospital
Facial nerve palsy can be acute or insidious in onset and classified into central and peripheral types based on the site of involvement. The imaging modality of choice is based on the clinical history and examination findings that predict the site of a lesion affecting the facial nerve. CT and MR imaging play a crucial role in the diagnosis of multiple entities that may cause facial nerve palsy. The purpose of this educational exhibit is to review the anatomy, clinical findings, imaging protocols, and imaging findings of pathologies causing facial nerve palsy.

Educational Goals / Teaching Points
1. To review the imaging anatomy and the clinical findings pointing to the site of a lesion affecting the facial nerve. 2. To describe imaging protocols for assessment of the facial nerve. 3. To discuss the various entities that may manifest with facial nerve palsy based on the site of facial nerve involvement. 4. To illustrate the imaging findings of common and infrequent pathologies that can cause facial nerve palsy.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
The imaging findings of pathologies causing central facial palsy will be illustrated, including acute infarction, demyelination, pontine tumors, and vascular or hemorrhagic lesions affecting the facial colliculus. In addition, imaging findings of intrinsic and extrinsic facial nerve pathologies causing peripheral facial palsy will be shown, including, inflammatory and neoplastic lesions.

Awareness of the anatomy and different clinical presentation in patients with facial nerve palsy aid in deciding the optimal imaging protocol for the evaluation of potential underlying lesions. We describe the implications of the imaging findings on patient management.