Cause of droopy eyelid- Bell's or known aneurysm?

Any docs out there? I went to the ER in December due to facial drooping. Since I could raise by eyebrow they ordered a MRI. I was told that I had a 11mm aneursym on the carotid by the opthalmic origion just below the brain. After my arteriogram they found a second 4mm PCOM on the other side in the brain. The small on was clipped in March. I was told the large one was in a spot too risky to treat. I still can't close my eye easily and the skin from just below the eyebrow folds over my lid. I was told I had Bell's, but I know Bell's is a "default " diagnosis. Can it possibly be caused from pressure from the aneursym? They're on the same side.

Cause of droopy eyelid- Bell's or known aneurysm?
As a medical provider,I am assuming you have been to a neurologist. Bell's Palsy affects only a certain cranial nerve with only certain effects (thus the reason the 'the eyebrow lift'). I am not aware of Bell's being a default diagnosis. The nervous system is exactly like an electrical system. Certain nerves are responsible for certain things. You can always tell what nerves are affected and at what level by the responses that you get in any certain area of the body. The areas of the brain are somewhat like that also. I can see where it would seem logical to you that if the aneurysm is on the same side as the droop that it could be related....but that is not necessarily how the body is wired. Neurology is very complicated, which is why it takes so many years of advanced study. You should understand what is going on with your body...that is part of what you are paying for with medical services. If this area of the services is lacking....insist on answers.....get a second opinion. Be sure you understand. It is very important that you are part of the medical treatment and plan.....medical care is a MUTUAL relationship. You need to understand this so you can make some very important decisions. The days of medical care where the patient simply put themselves in the god-like hands of the doctors is over.....so insist.
Reply:I'm not sure I see what difference it makes what is causing the eyelid droop (ptosis) but it could be caused by either condition.
Reply:Bell's Palsy involves cranial nerve 7, which is the "facial" nerve. Whenever this nerve is affected, you would expect a paralysis of one side of the face. This usually involves drooping of the mouth (such that there can be drooling on that side), and also can include inability to tightly close the eyelid on that side.





I don't think you have Bell's Palsy. I think its just a term they are throwing out. Do you have more of an inability to TIGHTLY close the eye on that side, or just a droopy lazy eyelid (which involves more of CN III)?





Mostly likely, due to the location of your aneurysm, it is impinging on cranial nerve 3, which controls the eye muscles as well as the muscle that controls the eyelids. CN III runs very close to the carotid artery, so if there is a bulge in the artery it can also press on the nerve.





Usually when cranial nerve 3 is impinged on, its the smaller functions on that nerve that are affected first, such as closing the eyelid. If the impingement is very strong, then eye control movements are affected.





Do you have any vision problems?





Another clue that might help you determine if cranial nerve 3 is involved is to see how your pupils respond to light. CN III controls pupil reaction to light.
Reply:The aneurysm may clipping a nerve branch to the lid causing the tarsal droop. YOu need to see an endovascular neurosurgeon for an opinion on wether they can coil the aneurysm. You are at high risk of intracranial bleeding. Control your vascular risks of hypertension, smoking, choesterol etc