Which one of the following is not a recognised cause of facial palsy?
A. AIDSPfeiffer’s syndrome. This is not a cause of facial palsy. The causes of facial palsy can be broadly divided into intracranial, intratemporal and extratemporal. Several patterns of facial nerve dysfunction point to a nonidiopathic cause: simultaneous bilateral facial palsy (Guillain-Barré syndrome, sarcoidosis, pseudobulbar palsy, syphilis, leukaemia, trauma, Wegener’s granulomatosis), unilateral facial weakness slowly progressing beyond 3 weeks (cholesteatoma, facial nerve neuroma, metastatic carcinoma, adenoid cystic carcinoma), slowly progressive unilateral facial weakness associated with facial hyperkinesis (facial nerve neuroma), no return of facial nerve function within 6 months after abrupt onset of palsy (facial nerve neuroma, adenoid cystic carcinoma, basal cell carcinoma), ipsilateral lateral rectus palsy, and recurrent unilateral facial palsy (facial nerve neuroma, adenoid cystic carcinoma, meningioma).
Several viruses have been implicated including Varicella zoster, Herpes simplex and Epstein-Barr. Facial paralysis occurs in 11% of patients with Lyme disease; in 30% of cases, the paralysis is bilateral. AIDS is also an increasingly common cause of bilateral involvement.
Pfeiffer’s syndrome is not associated with facial nerve palsy. This syndrome is characterised by: craniosynostosis (most often of the coronal and lambdoid), and midfacial hypoplasia with receded cheekbones or exophthalmos. Ocular proptosis and hypertelorism, broad thumbs and big toes are other features. The mental capacity of Pfeiffer patients is usually in the normal range.