Pathology · single question
RAMSAY HUNT SYNDROME CASE (continued): A patient with facial nerve palsy has drooling saliva and cannot blink his eye. Which of the following would NOT be expected to occur?
Show answer and explanation
Correct answer: D. Glaucoma
Facial nerve (CN VII) palsy results in inability to close the eye (lagophthalmos), which leads to exposure keratitis/corneal ulceration. Loss of taste on the anterior 2/3 tongue (via chorda tympani) and hyperacusis (stapedius muscle paralysis) are also expected. Glaucoma is NOT a direct consequence of CN VII palsy — it is caused by impaired aqueous humor drainage (e.g., from blockage of the canal of Schlemm), which is unrelated to facial nerve function.
- A. CORRECT (this is the EXCEPT). Glaucoma is caused by increased intraocular pressure from impaired aqueous humor outflow — this is not a consequence of facial nerve palsy.
- B. Incorrect (this DOES occur). Inability to blink causes the cornea to dry out, leading to exposure keratitis and potential corneal ulceration.
- C. Incorrect (this DOES occur). The chorda tympani (branch of CN VII) carries taste from the anterior 2/3 of the tongue — palsy causes ipsilateral taste loss.
- D. Incorrect (this DOES occur). The stapedius muscle (dampens loud sounds) is innervated by CN VII — palsy causes hyperacusis (painful sensitivity to sound).