FACIAL PARALYSIS. 



25.1 



berger. Holler's observations support those of Ellenberger, but it must 

 be allowed, as shown in a case related by Sehoneberger, that an animal 

 affected with this form of paralysis, if excited and forcibly driven, 

 may not only suffer from severe dyspnoea, but may even succumb. 

 In one case of double-sided peripheral paralysis the breathing was of 

 a snoring character, even when the patient was at rest, whilst during 

 inspiration the nostrils became contracted and the false nostrils 

 collapsed (Fig. 272). 



Diagnosis of central paralysis is not difficult, though determination 

 of the cause and its exact position require much care. Should the 

 paralysis be confined to one or both lips, it is peripheral ; 

 where the muscles both of the eyelids and 

 ears are affected at the same time, the 

 injury is above the point where the nerve 

 turns round the jaw. Central paralysis 

 may sometimes be recognised by the con- 

 tinued existence of reflex irritability in the 

 affected parts, showing that conductivity of 

 the nerve is not destroyed. 



Prognosis. Many cases of peripheral 

 paralysis recover in from four to six 

 weeks. Keturn of irritability on faradisa- 

 tion points towards recovery, and this 

 usually occurs gradually. When the animal 

 is in a state of rest, it may be noted that 

 the lip is returning to its normal position ; 

 should it be excited, however, the distortion 

 again becomes visible. A prognosis is, 

 therefore, best arrived at while the patient 

 stands quietly in the stable. Cases of incomplete paralysis gener- 

 ally recover ; those in which the eyelids and ears are affected are 

 not hopeful, and where tumours are the cause a cure is not 

 to be expected. Further, when the paralysis has been in existence 

 for more than two or three months, the prognosis is always 

 unfavourable. Double-sided is generally less hopeful than single- 

 sided paralysis, while, if the appearances point to some central cause, 

 little hope of cure can be entertained. 



Treatment. In one-sided incomplete paralysis the food which has 

 accumulated in the cheek must be removed after each meal. Nothing 

 further is necessary. In complete paralysis of one side, soft, easily 

 masticated food should be given, and the skin over the neck of the 

 lower jaw, where the nerve crosses the bone, rubbed with a mild 



Fig. 272. — Position of nostrils 

 and nose in double-sided 

 (peripheral) facial paralysis 

 (from a photograph). 



