Course. Diagnosis, Treatment. 725 



in many cases within a few days, but in some cases only after 

 several weeks. It occurs only rarely that a certain amount of 

 weakness of the muscles of the face persists when the paraly- 

 sis has persisted for a long time. If the seat of the disease is 

 in the temporal bone or the cranial cavity, the prognosis is, as a 

 rule, unfavorable. The same holds good in cases of bilateral 

 paralysis owing to the difficulty of respiration and of taking 

 nourishment. 



Diagnosis. The symptoms of facial paralysis are so strik- 

 ing and characteristic that it is only the localization and deter- 

 mination of the cause that presents any difficulty. Paralysis 

 due to a lesion of the facial trunk involves all three branches. 

 If the lesion is situated outside the stylo-mastoid foramen there 

 is no paralysis of the muscles of the ear, because the nerves 

 supplying these muscles separate from the main nerve imme- 

 diately outside this foramen and consequently escape injury. 

 On the other hand, even in neuritis of tlie trunk, all the branches 

 are not always involved. The nearer the lesion is to the inferior 

 maxillary branch the less likelihood there is of the auriculo- 

 palpebral branch being injured. The orbicular muscle and the 

 corrugator escape if the conductivity of the nerve is destroyed 

 at or near the seat of injury. This is usually the case in the 

 ' horse. If the nerve be diseased within the temporal bone there 

 may be pain on pressure in this region and loss of hearing. It 

 is also possible that if the nerve be injured in horses near the 

 auditory meatus, the geniculate ganglion or somewhat deeper, 

 there may be regurgitation. If the intracranial portion be dis- 

 eased there may be functional disturl)ances of neighboring 

 nerves, the auditory and abducens (deafness and squinting of 

 the eye on the diseased side), and there may even be hemiplegia. 

 In these cases all the branches are, as a rule, involved, but if the 

 nucleus be diseased individual branches may be more or less 

 free. Infranuclear paralysis involving exclusively the lips, 

 nose and cheeks, is almost ^\4thout exception due to a lesion at 

 the geniculate portion, if no other nervous sjmiptoms are 

 present. 



Horses in poor coudition or old horses frequently allow the lower lip to hang, 

 but a prick with a neeille always causes a contraction. In eases of facial paralysis 

 this movement is absent liecanse the paralysis is almost always of infra-nuclear 

 origin and there is consequently a loss of reflex irritability. 



Treatment. Paralysis due to an injury or to cold tends to 

 disappear without anj special treatment, especially if the ani- 

 mal be turned out. It appears to be probable that auto-mas- 

 sage plays some part in the cure. Systematic massage of the 

 muscles of the face and ear and the application of electricity 

 must be borne in mind. In cases that are due to abscess-forma- 

 tion or the growth of neoplasms surgical interference may have 

 the desired result. 



Soft food should be given and particles remaining between 



