left side of face, imperfect closure of
left eye, and deviation of face to right side.

(From a photograph lent by Dr. Edwin Bramwell.)]

When the paralysis is bilateral, the symmetrical appearance of the
face renders the condition liable to be overlooked.

_Treatment._--In addition to removing the cause, when this is
possible, recovery of function may be promoted by the administration
of drugs, such as potassium iodide, strychnin, or iron, by the
application of blisters, or by massage and electricity. These measures
are most useful in cases due to blows or exposure to cold. When the
nerve is accidentally divided in the course of an operation on the
face, it should immediately be sutured. So long as the electrical
reactions of the affected muscles indicate an incomplete lesion,
recovery may be confidently expected (Sherren). When the reaction of
degeneration is present and the paralysis has lasted for more than six
months, there is little hope of recovery, and recourse should be had
to operation, to restore the function of the nerve by grafting its
distal end on to the trunk of the hypoglossal nerve. To prevent
paralysis of the tongue the lingual nerve may be divided, and its
proximal end anastomosed with the distal end of the hypoglossal.

The facial may be grafted on the accessory nerve, but the associated
movements of the face which then accompany movements of the shoulder
often prove inconvenient.

_Facial Spasm._--Clonic contraction of the facial muscles (histrionic
spasm) occasionally results from irritative lesions in the cortex or
pons. Sometimes all the muscles are involved, sometimes only one, for
example the orbicularis oculi (palpebrarum)--blepharospasm. This
condition may be induced reflexly from irrigation of the trigeminal
nerve, notably of branches that supply the nasal cavities and the
teeth.

The _treatment_ consists in removing any source of peripheral
irritation that may be present, in employing massage, and in
administering nerve tonics, bromides, and other drugs. In severe
cases, the facial nerve may be stretched with benefit, either at its
exit from the stylo-mastoid foramen or on the face.

VIII. _Acoustic_ or _Auditory Nerve_.--The acoustic nerve is liable to
be damaged along with the facial in tumours of the cerebello-pontine
angle, and in fractures which traverse the internal auditory meatus.
Both nerves also may be torn across just before they enter the meatus
in severe brain injuri