Trigeminal, Facial (with Aberrant Regeneration), and Vestibulocochlear Nerve Palsies Following Tumor Resection

This is a 30-yo-woman who underwent resection of a right trigeminal schwannoma. Post-operatively, she was vertiginous with a clearly + head impulse test to the right (and spontaneous left-beating nystagmus), had lost hearing in the right ear, had no facial sensation on the right, and had a right lower motor neuron facial palsy. This video was taken 6 months later, and her right trigeminal neuropathy is apparent with severely impaired corneal blink reflex (decreased sensation on the right face, V1-3), there is moderate right facial weakness with clear synkinesis (e.g., blinking causing right lower face contraction, and lip excursion causes the right eye to close - at baseline the right lower face looks contracted and the palpebral fissure is narrowed, all because of aberrant regeneration involving the branches of the facial nerve), and there was a very subtle catch-up saccade to the right with head impulse testing (mild left-beating nystagmus was only noted with fixation removed during occlusive funduscopy/with Frenzel goggles).