There are usually multiple potential causes for a given combination of symptoms. Therefore, diagnostic tests, in addition to a physical examination, routine laboratory tests and your medical history, are necessary.
For example, your case of facial paralysis could present itself as facial tightness, drooping, twitching or asymmetry in facial characteristics, all of which are symptoms of inflammation, infection or an underlying disease. Therefore, you will need to do one or more of the following diagnostic tests to know which condition has led to your paralysis symptoms.
An Audiogram: Hearing and Balance Testing
Facial paralysis can cause conductive or sensorineural hearing loss. An audiogram test is used to diagnose hearing loss and balance problems and to help define the cause of facial paralysis. For example, skull base tumors can cause facial paralysis-related hearing loss.
Electrical Testing: Electromyography (EMG)
Electromyography examines facial nerve health and integrity. It is a neuroelectrophysiological test in which patients are asked to contract specific facial muscles with tiny needles inserted into them, relaying nerve signals to a machine for recording. If there is no signal, it signifies a chronically denervated muscle – one that can no longer be reinnervated.
Electrical Testing: Electroneurography (ENOG)
Audiologists use electroneuronography to examine facial nerves. Two electrodes affixed to the face gather up facial nerve fiber signals. Comparing signal size, strength and speed measures facial nerve integrity. ENOGs performed on multiple days allow for nerve health assessment.
Radiographic: CT Scan and/or MRI
Imaging can typically diagnose facial nerve dysfunction. CT and MRI scans assist in revealing bony facial canal and soft tissue anomalies. For facial paralysis diagnosis, we will look at the temporal bone, brainstem/cerebellopontine angle and parotid gland. We may also perform chest imaging to rule out or diagnose systemic diseases.
Additional Special Tests
Special tests could include blood tests (like an ESR) to check for blood sugar levels and inflammation to see if the patient has diabetes.
The Sooner You Start Diagnostic Testing, the Better
There is no one-size-fits-all approach to treating facial paralysis. Instead, New York Facial Paralysis uses multidisciplinary team care because a comprehensive approach is the most effective strategy for treatment. Furthermore, since the road to diagnosis can involve many steps, the sooner you schedule a consultation with us, the better.