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Of main consideration regarding the optimal management for a person with facial paralysis are the cause and duration of the paralysis. In cases of congenital (present since birth) facial paralysis, the facial nerve and facial muscles may not have developed appropriately or may be absent.Attempting to provide a new nerve source to these muscles, then, is not logical or possible, but other types of reconstruction are possible.nce a muscle has lost its nerve source for any reason, there is a window of opportunity to provide a nerve to those original muscles. After that window has passed, usually about 12-24 months, the original muscles can no longer accept a nerve. In those cases, a nerve supply as well as new muscle must be provided.
1 The deep branch of the radial nerve is affected, so the muscles in the posterior compartment of the forearm are paralysed. 2  The patient is unable to extend the wrist and fingers. 3  Unopposed flexion of wrist occurs, known as wrist drop.here are four branches of the radial nerve that provide cutaneous innervation to the skin of the upper limb: 1  Lower lateral cutaneous nerve of arm â Innervates the lateral aspect of the upper arm, below the deltoid muscle. 2  Posterior cutaneous nerve of arm â Innervates the posterior surface of the upper arm.