Čes-slov Pediat 2026, 81(5):253-258 | DOI: 10.55095/CSPediatrie2026/040

Peripheral facial nerve palsy

Jakub Malý¹, Miroslav Mamiňák², Ivana Monková³

¹ Klinika dětí a dorostu, 3. lékařská fakulta, Univerzita Karlova a Fakultní nemocnice Královské Vinohrady, Praha

² Klinika dětské neurologie, 2. lékařská fakulta, Univerzita Karlova a Fakultní nemocnice Motol a Homolka, Praha

³ Klinika rehabilitace a tělovýchovného lékařství, 2. lékařská fakulta, Univerzita Karlova a Fakultní nemocnice Motol a Homolka, Praha

The facial nerve is the seventh cranial nerve, although primarily known for the innervation of the muscles of facial expression of the head and neck, it has mixed functions. Lesions of

this nerve are classified as central, involving the cortical region and the corticonuclear tract, or peripheral, affecting the facial nuclei, the facial nerve and the nervus intermedius. Peripheral facial nerve palsy is not uncommon in the paediatric population and represents one of the most frequent mononeuropathies in childhood. Detailed knowledge of the anatomical course and functions of the

seventh cranial nerve is essential for proper clinical examination and accurate diagnosis. The differential diagnosis is broad and determines the appropriate therapeutic approach. Facial nerve palsy may have congenital, infectious, autoimmune or traumatic etiology. As facial nerve palsy may represent a manifestation of neuroinfection, lumbar puncture with cerebrospinal fluid analysis is

considered a standard diagnostic procedure. In diagnostically unclear cases, contrast-enhanced magnetic resonance imaging of the brain is used to detect facial nerve edema or possible tumor involvement. Regardless of etiology, rehabilitation plays a key role in management. Therapeutic approaches include physiotherapy (soft-tissue techniques, massage, subcutaneous tissue mobilization, and

neurophysiologically based methods), electrostimulation, kinesiotaping, and less commonly, balneotherapy. Parental education is essential. Delayed initiation of rehabilitation may lead to irreversible complications such as keratopathy, synkinesis, contractures or hearing impairment.

Keywords: facial nerve, Bellˇs palsy, Lyme borreliosis, rehabilitation, physiotherapy, synkinesis

Accepted: July 28, 2026; Published: July 1, 2026  Show citation