Facial palsy in closed head injuries : the prognosis / J.W. Aldren Turner.

  • Turner, J. W. Aldren (J. William Aldren), 1864-1945.
Date:
[1944]
Catalogue details

Licence: Public Domain Mark

Credit: Facial palsy in closed head injuries : the prognosis / J.W. Aldren Turner. Source: Wellcome Collection.

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    3 monkeys in which there were definite associated movements, and demonstrated branching of the regenerating axons which gives one axis cylinder connexions over a wide area of the facial musculature. Of the 3 remaining cases in my series, 1 has been followed up for over two years and there is no return of/ voluntary power ; if has proved impossible for me to examine the other 2, but in 1 case the patient’s doctor reported that there had been no recovery after 18 months, and the third patient reports that there has been no improvement in two years. It is noteworthy that in 2 of these 3 bad results there was an acute otitis media on the side of the facial palsy after the injury ; it will be recalled that there was also an acute otitis media in the only case among the delayed palsies where there had been no recovery after 6 months. These findings, though perhaps not conclusive, suggest that a middle-ear infection complicating a traumatic facial palsy is of bad import. In the early stages of a complete palsy it is impossible to tell whether rapid recovery will follow or whether regeneration of the nerve will have to be waited for. After three weeks the electrical reactions are of some help ; if a faradic response is still obtainable rapid recovery will follow in most cases. In some of the later cases of the series electromyographic records were made by Captain Graham Weddell, ramc, and it is hoped that further work of this type will make it possible to tell at earlier stages whether thg nerve has actually de¬ generated. Bilateral facial palsy.—There wa& one case in the series of a bilateral traumatic facial palsy in which both sides recovered completely in the course of 8 weeks— this case was admitted to hospital about a fortnight after his injury ; the previous records were incomplete, but it appeared that both facial palsies had been delayed in onset. There are a number of records of bilateral cases (Keiper 1923) and the prognosis does not seem to differ from the unilateral cases. ETIOLOGY In at least 51 of the 70 cases there was bleeding from the ear on the side of the facial palsy immediately after the injury, and it is likely that the figure is really higher