Diseases of the nervous system : a text-book of neurology and psychiatry . fthe palpebral fissure, and a droop-ing of the outer angle of the eye-brows on the affected side. Pontinesyndromes frequently show thesesigns. See Midbrain of the facial musculature is met with in cortical, or corpuscallosum lesions. Here the patient loses the power to make propermimetic movements. He may not be able to close the eye on theparalyzed side, independently of the other. Furthermore, in corticalneurone palsy the tongue protrudes to the paralyzed side, or may beunable of protrusion at all. Spe
Diseases of the nervous system : a text-book of neurology and psychiatry . fthe palpebral fissure, and a droop-ing of the outer angle of the eye-brows on the affected side. Pontinesyndromes frequently show thesesigns. See Midbrain of the facial musculature is met with in cortical, or corpuscallosum lesions. Here the patient loses the power to make propermimetic movements. He may not be able to close the eye on theparalyzed side, independently of the other. Furthermore, in corticalneurone palsy the tongue protrudes to the paralyzed side, or may beunable of protrusion at all. Speech disturbances are frequent. In cortical facial monoplegias—or hemiplegias with facial involve-ment—there are no atrophies, the electrical reactions are not involved,and secretory and taste modifications are absent. Cortical and subcortical irritation may give rise to facial convulsivemovements—spontaneous laughing or crying movements. The facial mimetic movements of purely psychogenic origin, tics,etc., are numerous and often closely resemble choreic Fig. 106.—Pseudobulbar palsy.(TUney.) DISEASES OF THE FACIAL NERVE 219 Pontine Facial Lesions.—Here the nuclei of the peripheral neuronebeing involved one expects to find all of the branches affected, butinasmuch as there are different groups of nuclei, occasionally, as inpoliomyelitis for example, certain muscles are involved and othersare not. A general lesion here will cause a total palsy of the muscleswith atrophy and loss of electrical reactions. There are no changesin taste, nor hearing in the pure nuclear cases. Lesions here are apt also to involve the third nerve, also the pyra-midal tract fibers, and the sensory fibers of the fillet, hence a varietyof hemiplegic or hemianesthetic syndromes—crossed or lower alternatehemiplegias. (See Section on Midbrain.) Supranuclear pontine lesions may rarely be double (Pseudobulbarpalsy types). Peripheral Facial Palsies.—Bells Palsy more properly
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