How Do You Test the Facial Nerve?
Examination of facial movements should be more than just asking the patient to smile - it also includes asking them to:
- frown, raise the eyebrows and to look for forehead furrowing
- blow out their cheeks
- listen to speech ('P' sounds may be difficult), ask the patient to whistle
- look at eye closure (is there Bell's phenomenon?)
- oppose forced eye and pursed lip closure
- look at action of platysma
Subtle signs of early Bell's palsy.
- Unilateral reduced blinking on the affected side
- Reduction in the nasolabial fold (skin crease between lower corner of the nose and the corner of he mouth) - also seen in subtle UMN lesions
