title: Delayed facial nerve palsy after temporal lobectomy for epilepsy: report of four cases and discussion of possible mechanisms.
abstract: Four cases of idiopathic peripheral facial nerve palsy were documented after 110 consecutive resections of the temporal lobe for intractable epilepsy. In 3 of the 4 cases, the palsy was ipsilateral to the side of the temporal lobectomy. The onset of facial weakness was delayed 7 to 13 days after surgery (mean, 9.7 days). One patient underwent facial electroneurography, which documented 17% of normal facial motor function at the height of his weakness and the absence of the acoustic stapedius reflex. All patients were treated with prednisone (60-80 mg per day by mouth for 10-14 days, tapering off throughout the subsequent week). Facial function recovered fully in all patients within 6 to 8 weeks. Possible mechanisms are discussed, including heat and/or mechanical trauma to the facial nerve near the geniculate ganglion during resection of mesial temporal lobe structures.
authors.affiliation: Department of Neurological Surgery, Cleveland Clinic Foundation, Ohio.
authors.forename: J
authors.initials: J
authors.lastname: Anderson
authors.forename: I A
authors.initials: IA
authors.lastname: Awad
authors.forename: J F
authors.initials: JF
authors.lastname: Hahn
mesh_terms: D000328:Adult; D004833:Epilepsy, Temporal Lobe / Q000601:surgery*; D005158:Facial Paralysis / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D013702:Temporal Lobe / Q000601:surgery*