How to diagnosis of facial paralysis in newborns?

Foreign students have been within 24 hours after the performance has a retrospective study of 95 cases of facial paralysis in children. Among them, 74 were caused by intrauterine or birth trauma, 21 are congenital reasons. Group of 19 were totally paralysis in traumatic, under 3 names only support totally paralysis; 33 gastroparesis, 19 under the name only gastroparesis. 55 as a forceps delivery, 10 for natural childbirth, cesarean section 9 are. According to the number of deliveries and with birth palsy estimated incidence is approximately 0.5%. Tracking observation in 45, 41 to become fully functional, is not left any sequelae, 3 is not fully recovered, 1 gastroparesis no function. No fractures were found, but head hematoma may be intracranial injury. In congenital causes in the, its diagnosis including Mobius,Golbenhar; heart surface, Poland, four species comprehensive syndrome and the various malformation, most often with made of malformation is different degree of small ear and external auditory canal atresia, 2 name has double side small ear, but only in degree serious of side has paralysis; other with onset has outside exhibition neural paralysis 3 name, heart malformation 3 name, tongue Xia neural paralysis 2 name.

Groups often traumatic forceps in childbirth, ecchymosis ear week because obviously, but more low forceps or export. No forceps and cesarean section 12.5% of normal natural childbirth trauma cases. Mastoidectomy in newborns has not yet been formed, stem and mastoid hole located under the skin, therefore, extremely vulnerable to the facial nerve intrauterine pressure from a shoulder injury, from a pelvic injury or forceps injuries during labour. Damage or outside of the temporal bone, or within the temporal bone, injury is different. Some traumatic paralysis cannot be fully recovered, possibly facial nerve Canal bruised, tympanic or temporal bone hematoma may have blood. Congenital facial paralysis is not easy to restore.

For all parts of facial paralysis in newborns should be full evaluation and follow-up, should identify its paralysis for complete or part of the support and involvement, with or without blood the tympanic cavity, ear week ecchymosis, but also for facial nerve stimulation test.

Such children can be divided into four groups:

See within three days after the first group included in the health and facial nerve excitability test can cause excitability, so the distal nerve, motor end plate and hemifacial exist and function. Should be based on observation of nerve excitability test track up to functional recovery of evidence.

Second leads group is to be excited and exciting threshold increased, suggesting imminent changes in addition to neural. Injury during childbirth, and first set of differences is nerve damage heavier. Should also be temporal bone radiography faults, acoustic reflex test and Schirmer test.
The third group is that can not lead in the first three days of excitement, so the paralysis occurs before birth, is not caused by birth trauma. Should consider whether it is or/and surfaces of the facial nerve muscle absent. Where electrical stimulation is no reaction, that is, no neither innervation in the facial muscles, or viviparous. Your facial muscles such as fibrillation potential exists, but the lack of function of innervation. Temporal bone radiography of fault should be carried out, listen to reflection and Schirmer test.
The fourth group is seen in three days later, first surface nerve stimulation test, has proved to be a certain number of movements of axonal excitability intact, should be stimulated to determine the entire function is continuous improvement or deterioration. If not led excitability, checks should be EMG; where electrical stimulation is no response, indicating that no facial or facial muscles, there is no innervation. Fibrillation potential indicates that the innervation of the facial muscles do not have, radiography and lesion of line fault location. Shown that neural excitatory threshold increase EMG show fibrillation potentials, proven or x ray and signs are in temporal bone injury, probes should be carried out; if not led excitability, EMG is atrial fibrillation no reaction, x-ray film proved to be a congenital damage or signs, the row of muscle biopsy. Biopsy proven when no muscle, at the right age with temporalis or masseter muscle transfer action of facial reconstruction. If congenital facial nerve paresis, at least two-year follow-up should be carried out to determine the degree of the deformity.