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StatPearls, LLC

  • Bell Palsy
  • Decompression Sickness
  • Embolism, Air
  • Facial Paralysis
  • Vertigo

Alternobaric Facial Paresis

Alternobaric facial paresis (AFP), also known as facial baroparesis, baroparesis facialis, or alternobaric facial nerve palsy, is a rare and usually transient neurapraxia affecting the seventh cranial nerve (CNVII, the facial nerve) due to pressure-related effects in the tympanic cavity. This condition arises when pressure in the middle ear compresses the facial nerve against the cochlear promontory, in the medial wall of the tympanic cavity, resulting in symptoms resembling Bell’s palsy. AFP is best known as an injury associated with underwater diving, although it can also develop secondary to changes in ambient pressure during airplane ascents or descents. In many cases, prompt relief can be achieved through maneuvers to equalize middle ear pressure, such as yawning, swallowing, or other explicit exercises for re-establishing pressure equilibrium. AFP may also contribute to alternobaric vertigo, and the rapid onset and resolution of facial palsy in response to changes in ambient pressure further underscore the connection between middle-ear over-pressure and the development of this condition. Divers should be particularly cautious, as misdiagnosis may lead to unnecessary recompression treatment and diving activity restrictions, particularly when confused with neurologic decompression sickness or air embolism. This activity reviews the presentation, causes, recognition, management, and preventive strategies, empowering healthcare professionals with the required knowledge and necessary tools to provide optimal care for patients with AFP.

Credit & MOC Details

Credit information is provided by the course provider. We recommend confirming credit eligibility with the provider or your licensing board before starting the activity.

Credit types

AAPA Category 1 Credit™Up to 1.5 creditsAMA PRA Category 1 Credit™Up to 1.5 creditsNursingUp to 1.5 creditsPharmacyUp to 1.5 credits

MOC types

ABS — Accredited CMEUp to 1.5 pointsABPM — Accredited CMEUp to 1.5 pointsABPATH — Lifelong LearningUp to 1.5 pointsABA — Lifelong LearningUp to 1.5 pointsABTS — Accredited CMEUp to 1.5 pointsABIM — Medical KnowledgeUp to 1.5 pointsABS — Self-AssessmentUp to 1.5 pointsABP — Lifelong Learning and Self-AssessmentUp to 1.5 pointsABPM — Self-AssessmentUp to 1.5 pointsABOHNS — Self-AssessmentUp to 1.5 pointsABTS — Self-AssessmentUp to 1.5 points

FDA REMS

No

Qualifies for MIPS

No

Target Specialties

Cross-Specialty

Relevant across 11 specialties.

Pricing

Fee varies

This provider typically $49–98

See fees on statpearls.com

Listed by the provider

  • Article / monograph / reference
  • Credit · Up to 1.5 credits
  • MOC · Up to 1.5 points
  • Fee varies · this provider typically $49–98
  • Released
    Sep 1, 2026
  • Last day to claim credit
    Sep 1, 2029 3 years left

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