CASE HISTORY / CLINIC:
39-year-old patient with sudden paresis of the left facial nerve. The branches to the mouth, eye and forehead are affected. Light pains around the left ear. Normal findings of ear microscopy .


FINDINGS:
The post-contrast T1-weighted axial image of the cerebellopontine angle shows high signal intensity along the course of the facial nerve through the left middle ear (image above). The right facial nerve doesn't show any hyperdensity. The post-contrast T1-weighted coronal image (picture below) also shows a significant enhancement of left facial nerve in it's course through the middle ear. The right facial nerve in comparison doesn't demonstrate any hyperdensity.


DIAGNOSIS:
Neuritis of the facial nerve most probably resulting from viral infection.


DIFFERENTIAL DIAGNOSIS:
Alteration of the facial nerve e.g due to trauma



Web resources:

1) Gesundheit.de
2) Amersham Health
3) Neuritis.de