Which of the following describes a patient with facial drooping on the right side but who CAN still close their eyes (suggesting lower motor neuron vs upper motor neuron lesion)?

Correct answer: B. Lower motor neuron (LMN) CN VII palsy from a bacterial/neoplastic cause at the parotid/ramus level

• A. UMN stroke affects the contralateral face and SPARES the upper face (eyes/forehead) — possible given ability to close eyes.
• B. Correct. The ability to CLOSE EYES on the affected side versus inability helps distinguish LMN vs UMN facial nerve palsy. Wait — if the patient CAN close their eyes on the drooping side, this actually suggests UMN lesion (forehead and eye closure are SPARED in UMN lesions because the upper face has bilateral cortical representation). If the patient CANNOT close eyes, it is LMN (all facial muscles affected). In this case, the swelling at ramus + facial drooping + ability to close eyes suggests a MASS LESION (neoplasm) at the parotid/ramus causing LMN palsy — or a UMN finding. Given the swelling at the ramus, the cause is most likely bacterial/neoplastic at the parotid level affecting CN VII.
• C. Trigeminal neuralgia causes PAIN, not motor weakness.
• D. Glossopharyngeal neuralgia causes throat/ear pain — not facial droop.