Muscles of Facial Expression and Taste (CN VII)

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Look for asymmetry in facial shape or in depth of furrows such as the nasolabial fold. Also look for asymmetries in spontaneous facial expressions and blinking. Facial weakness may be difficult to detect in cases where it occurs bilaterally, also known as facial diplegia, because the facial weakness is symmetrical. Ask patient to smile, puff out their cheeks, clench their eyes tight, wrinkle their brow, and so on. In some cases, unilateral facial weakness is elicited selectively by either voluntary smile or by spontaneous laughter, so both should be tested. Old photographs of the patient can often aid your recognition of subtle changes.

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