FACIAL NERVE (VII) DISORDERS
Facial Nerve Front , Search , Index , Links , Pathology , Molecules , Syndromes , Muscle , NMJ , Nerve , Spinal , Ataxia , Antibody & Biopsy , Patient Info FACIAL NERVE (VII) DISORDERS Anatomy Bell's palsy Differential diagnosis Facial nerve: Anatomy 2 roots Motor from facial nucleus Nervus intermedius Sensory afferents: Skin & taste (to nucleus tractus solitarius) Preganglionic parasympathetics (from superior salivatory nucleus) Branches Large petrosal: Lacrimation & salivation Nerve to stapedius muscle Chorda tympani: Taste Sensory auricular branch Sensation of posterior external auditory canal & inferior pinna of ear Some axons may arise from vagus (Arnold's nerve) Motor: Facial muscles Facial nerve: Anatomical Diagram External link Brainstem anatomy Nerve anatomy: USUHS ; Yale Facial nerve paralysis: Signs Facial asymmetry Eyebrow droop Loss of forehead &d nasolabial folds Drooping of corner of mouth Uncontrolled tearing Inability to close eye Lips cannot be held tightly together: Diificulty keeping food in mouth Facial muscle atrophy (Late) Facial Paresis: Left Bell's Palsy 8 Sir Charles Bell Epidemiology Lifetime prevalence: 6.4 to 20 per 1,000 Incidence: Increased with age Overall: 0.5 per year per 1,000 Age 20: 0.1 per year per 1,000 Age 80: 0.6 per year per 1,000 Male = Female Recurrence: 7% Side: Right in 63% Increased incidence: Diabetes; Pregnant females Pathogenesis Evidence for herpes simplex type 1 infection Clinical Features Onset Paralysis: Progresses to maximal defecit over 3 to 72 hours Pain (50%): Near mastoid process Excess tearing (33%) Other: Hyperacusis; Dysgeusia Signs Facial weakness All branches of nerve: Upper & Lower Unilateral: Bilateral in < 1% Degree: Partial (30%); Complete (70%) Stapedius dysfunction (33%): Hyperacusis Lacrimation: Mildly affected in some patients Taste: No clinically significant changes in most patients Sensory loss 7 Mild or None May be present on face or tongue: On side of paralysis Possibly related to involvement of greater superficial petrosal nerve Prognosis better Incomplete paralysis Early improvement Slow progression Younger age Normal salivary flow Normal taste Electrodiagnostic tests normal Nerve excitability Electrogustometry Course Facial Paresis: Right Widened palpebral fissure Improvement onset: 10 days to 2 months Plateau: 6 weeks to 9 months Residual signs Synkinesis Frequency: ~50%; May be reduced by corticosteroid treatment May be treated with botulinum Probably due to misregeneration of nerve Face weakness: 30% Contracture: 20% Crocodile tears: 6% Blepharospasm: May occur years after paralysis Treatment of Bell's palsy Statistical degrees of benefit from drug treatment Prednisone + Acyclovir > Prednisone > Acyclovir More benefit when treatment started within 3 days of onset No benefit from treatment starting more than 10 days after onset Corticosteroids Use within one week of onset Adults: Prednisone 80 mg qd x 5 days Children: Prednisone 1 mg/kg/day After initial dose: Taper off over 7 to 10 days Acyclovir 5 Use within 3 days of onset Adults 2,000 mg per day (400 mg 5x/day) for 7 days With varicella zoster 4,000 mg per day Children: 80 mg/kg per day for 5 days ? More effective in Ramsay-Hunt syndrome Alternative anti-viral: Valacyclovir Protect eye from exposure ? Facial exercise Laboratory CSF: Protein high in 30%; Cells in 10% Calorics: Often reduced on affected side CNS imaging (MRI with gadolinium) indicated when No improvement in facial paresis after 1 month Hearing loss Multiple cranial nerve deficits Signs of limb paresis or sensory loss VII disorders: Differential Diagnosis Unilateral VII weakness Idiopathic: Bell's palsy Sarcoid & other granulomatous disorders Infection Leprosy : Especially with paralysis of upper face Otitis media Lyme disease Herpes Zoster (Ramsay Hunt syndrome) Neoplasm & Masses Trauma Cardiofacial syndrome :Lower lip or complete facial palsy Familial CNS lesions Bilateral VII weakness Melkersson syndrome Möbius syndrome Guillain Barré Motor neuron disorders Myasthenia gravis Myopathies Leprosy An-α-lipoproteinemia (Tangier) Central VII lesions Pyramidal: Lower face paralysis with voluntary motion Emotional 2 : Face paralysis with emotion Anatomy: Dorsolateral pons lesion Disorders Superior cerebellar artery infarction Unilateral With Deafness, Horner's, or reduced Sweating Extrapyramidal disorders Bilateral Parkinsonism Hemifacial spasm Melkersson-Rosenthal syndrome l Chromosome 9p11; Dominant Clinical Onset 5 to 70 years Incomplete penetrance Recurrent facial palsy Unilateral or Bilateral May include loss of taste Edema: Facial, Lip & Eyelid; Non-pitting External link: Image Onset: < 16 years Lingua plicata (Scrotal tongue) Laboratory Eyelid pathology: Granulomatous lymphangitis Möbius & Congenital facial syndromes Möbius syndrome: General Features 4 General: Rhombencephalic maldevelopment Onset: Congenital Facial paresis Unilateral or Bilateral Upper > Lower Ophthalmoplegia Common Especially VI nerve: Inability to abduct past midline Patterns Bilateral: 90% Abducens nerve palsy, isolated: 9% Conjugate horizontal gaze paresis: 48% Duane retraction syndrome : 34% Congenital fibrosis of extraocular muscles : 9% Palate and pharynx dysfunction: 56% Dysarthria, nasal Poor feeding Chewing defects: Associated with malocclusion Normal masticatory muscle function Motor disability, general: 88% Poor coordination (83%) Hypotonia: Congenital Poland syndrome : Some patients Respiratory abnormalities: 19%; Early death Tongue weakness: Hypoglossal nerve involvement Hypoplasia Asymmetry Limited range of motion Malformations Hands: Deformities Legs: Hypoplasia Möbius & Congenital facial syndromes: Types Sporadic Associated with toxic exposure Attempted abortion using misoprostol: Odds ratio = 38 Cocaine MBS1 l Chromosome 13q12.2-q13; Dominant Clinical: See general features Congenital facial diplegia; ± Asymmetric Ophthalmoplegia, esp VI nerve Mental retardation ± Peripheral neuropathy Skeletal: Arthrogryposis ; Orofacial malformations; Rib defects Muscle aplasia Respiratory failure: Central; Associated with tegmental brainstem calcification Hypogonadotropic hypogonadism Pathology: Aplasia or hypoplasia of cranial nerves & nuclei Hereditary congenital facial paresis 1 (HCPF1) l Chromosome 3q21-q22; Dominant Nosology: MBS2 Clinical Facial weakness Asymmetric Unequal involvement of the 3 branches of the facial nerve No ophthalmoplegia Pathology Facial nucleus: Reduced numbers of neurons Facial nerve: Small Rhombencephalon & corticospinal tracts: Normal Hereditary congenital facial paresis 2 (HCPF2) l Chromosome 10q21.3-q22.1; Dominant 1 Nosology: MBS3 Genetics: Variable penetrance Clinical Facial weakness: Unilateral or Bilateral Hearing loss: Congenital deafness, or Progressive hearing loss with age Ophthalmoplegia Chromosome translocation l Chromosome 1q22 Genetics Mutation Reciprocal translocation between chromosomes 1 & 11: t(1;11)(p22;p13) Reciprocal translocation between chromosomes 1 & 2: t(1;2)(p22.3;q21.1) Mutation often on paternally derived chromosome Clinical Facial diplegia Ptosis Other cranial nerves involved in some patients: III, VI, VIII Facial deformities: Anteverted nostrils, Malformed and low-set ears Developmental delay: Mild Poland syndrome: 1 patient Congenital heart disease Atrial septal defects + Similar genetic changes in cardiofacial syndrome Carey-Fineman-Ziter syndrome l Recessive Facial Nerve Trauma & Tumors Trauma Petrous bone fracture Surgery: Middle ear; Mastoidectomy; Parotid gland Tumors & Masses 6 Tumor types Neuroma/Neurinoma/Schwannoma: Most common Meningioma Hemangioma: Produce defects even with small size Cholesteatoma Parotid gland Metastasis Carcinomatous meningitis Paget: Osteopetrosis Tumor location Most common: Geniculate ganglion & Tympanic region Tumors along multiple segments of VII nerve common Rare: Middle cranial fossa Signs Facial weakness: 82% Course: Weakness progressive Usually > 1 year Range: Over 2 to 120 months Hearing loss: Some patients; Conductive, sensorineural or mixed Tumor visible by otoscopy Other: Some tumors found incidentally Diagnosis: MRI from brainstem to parotid Treatment Surgery Residual or increased facial paresis common: More deficit after 1 year of symptoms Best prognosis after removal of hemangioma Hemifacial Spasm Onset Adults Typically 5th or 6th decade Younger patients: Rule out brainstem disease, MS Location: Orbicularis oculi muscle More common in women Contraction pattern Synchronous contraction of facial nerve innervated muscles Paroxysmal Involuntary Duration: Up to 1 minute May persist during sleep Usually unilateral Weakness: Unusual Triggers: Aggravating factors Emotion Fatigue Causes Recovery from Bell's palsy Associated with synkinesis & contracture Dolichoectatic brainstem artery Frequency: 30% Mechanism: Pressure on VII root entry zone Vessels: PICA; AICA; Vertebral Brainstem disease Idiopathic Course: Usually permanent without treatment Electrophysiology Brief bursts of action potentials High frequency (150-400 Hz) Normal motor units Variable rhythm & amplitude Lateral spread response 3 Stimulation: Facial nerve branch Response: In muscles not normally innervated by branch Related to cross transmission of facial nerve fibers Location: Probably at site of compression Treatment Botulinum toxin Microvascular decompression of VII nerve Morbidity & Mortality 5% Anticonvulsants Bright 1831 Barker T2 image: Brainstem & Cerebellum MRA: AP view Dolichoectasia of vertebral arteries Deviation to right (Arrows) Patient syndrome: R hemifacial spasm Return to Cranial nerve disorders Go to Facial Paralysis (Baylor) References 1. Am. J. Hum. Genet., 1999;65:752-756 2. Neurology 2000;54:1217 3. Muscle Nerve 2002;25:845849 4. Neurology 2003;61:327333 5. Otol Neurotol 2003;24:948951 6. Otol Neurotol 2003;24:942947 7. J Neurol Neurosurg Psychiatry 2005;76:10171018 8. Cleve Clin J Med 2005;72:398-401 7/13/2005 gorgeous skin and asS n a r k A t t a c k: Cerulean -- S n a r k A t t a c k Because this ass isn't going to kiss itself, honey. Recent Posts Rounding out the Sundance experience Park City Bad Mamma Jamma Better and Better Inauspicious, or: It's Hard To Be Bubba As Bad as I Wanna Be Belated Thank You... Resolutions Robert Frost Can Kiss My Ass It's a postcard My Wish List Blogs I Quite Like A Whole Lotta Nothing Arts & Letters Daily Boing Boing Defamer Go Fug Yourself Pitchfork THE BLACK TABLE The Morning News The Superficial - Because You're Ugly Unfogged dooce flavorpill SF Archives January 2006 December 2005 November 2005 October 2005 September 2005 August 2005 July 2005 June 2005 May 2005 April 2005 Categories Bacon and other goodness. Film Food and Drink Music No, YOU'RE gay! Poor beastie. Read the extra-clever bits! Television The Worst Day of My Life (in installments) Your hair really is awesome. You watch too much t.v. Give us a kiss! Subscribe to this blog's feed License Creative Commons Deed This work is licensed under a Creative Commons License . -- « And Yet No Fudge? | Main | Re-tooling » March 30, 2005 Cerulean Boy, there's nothing like the big box of crayons to teach the little ones some pretty good SAT words, not to mention a nice lesson in political correctness. When my old box got replaced by a new box, Indian Brown was gone. How could I possibly draw family members without Indian Brown? (Or was it Indian Red?) We are blessed with gorgeous skin and as kids we just ran and ran and ran and (stopping for breath) ran and ran around outside until our gorgeous skin was tanned into a Mowgli -tinted hue. And there's just no drawing Mowgli without Indian Brown. I mean, you could try, and in a moment of desperation I did make do with the poor neglected colors: Flesh plus Brown with a soupcon of Black. The resulting family portrait looked like an illustration from In Cold Blood and got me a trip to the school nurse for a severe talking to younglady . While sitting in detention with a handful of paste-eaters, I realized that Crayola didn't have Indian Brown disappeared - they just renamed it Siena. And I totally called bullshit because if you're going to rename anything they should have renamed Flesh first. Flesh. Ugh. Not 'Skintone' or 'White People' or 'Cracker,' but Flesh. Now, aside from the question of whose flesh Flesh is supposed to resemble, let's just go with the obvious and say it's the flesh of Anglo I-burn-in-the-sun/the-look-of-corporate-America flesh. Fine. But it doesn't even look like that. My handsome Irish-American dad was never that particular shade of peach, though of course I should add that the Irish do excel at choosing primary colors where their faces are concerned. Remember Tip O'Neill? A lovely crimson. Kennedys? All red. Especially JFK, and especially towards the end. [crickets.] (Too soon?) Anyhoo, the point is that through the wonder of a 64-crayon box I learned that the good folks at Crayola have a better handle on what Indians look like and a terrible sense of what their own WASP-y selves look like. This realization of their total lack of self-awareness is yet another one of those nuggets which has helped me not at all in life, but which I find interesting. Much in the way that I find it interesting that certain celebrities are the offspring of other celebrities, like Tippi Hedren, por ejemplo , or that you can shift gears without using the clutch, especially if it's someone else's car. Oh, and the 64-crayon box did teach me words like periwinkle and cerulean, which I'm sure got me those extra points on the SAT and which in turn set me ever so gingerly on the gilded path upon which I so merrily stroll today, all thanks to higher education begotten by a sesquipedalian vocabulary. Thank you, Crayola. In other news, I give you two celebrity blogs of some note. Here and here . (Via Waxy and some friends who will be sitting next to me in hell.) Posted at 12:23 PM | Permalink TrackBack TrackBack URL for this entry: http://www.typepad.com/t/trackback/2154089 Listed below are links to weblogs that reference Cerulean : » Crayola crayons from Life Link: S n a r k A t t a c k: Cerulean. There is nothing like a new box of crayons! :o) [Read More] Tracked on April 06, 2005 at 10:42 AM Comments (Too soon?) Johnny Carson used to say that he still couldn't get away with Lincoln jokes. So, not in your lifetime. Posted by: ogged | March 30, 2005 at 04:34 PM I realized at a very early age that the underside of my forearm is exactly the same color as the Flesh crayon. There was a time when that was cool. Now it's just gross. Posted by: janet | March 30, 2005 at 05:33 PM But I think they DID change the name of the "flesh" color, didn't they? Yes they did! I love how they say they changed it "voluntarily." Also note that they named it "indian" red because of pigment from India, not because of Native Americans. In any case, if you wanted a color for my skin, you'd have to go with "ghostly." Or "speckled," in the summer. And, no, I don't think it's too soon; I giggled all the way through this post. Posted by: Emma Goldman | March 31, 2005 at 09:08 AM I suppose all John-John jokes are out too then. Incidentally, anyone else feel stymied as a child in the face of yellow-green and green-yellow crayons? To my prepubescent eyes, they were identical. Posted by: moira | March 31, 2005 at 09:52 AM Re. "total lack of self-awareness," kinda reminds me of a friend of mine who always says, "it's just amazing what white people will say to each other when they think no one else is listening." Posted by: bitchphd | April 04, 2005 at 08:55 AM Post a comment If you have a TypeKey or TypePad account, please Sign In You are currently signed in as (nobody) . Sign Out Name: Email Address: URL: Remember personal info? Comments: Body Butter Overall rating:Compare Prices and Read Reviews on The Body Shop Coconut Body Butter at Epinions.com Join Epinions | Help | Sign In Bath & Body Beauty All Categories Advanced Search Home > Wellness & Beauty > Bath & Body The Body Shop Coconut Body Butter Overall rating: Reviewed by 14 Epinions users Write a Review Compare Prices View Details Read Reviews Subscribe to reviews on this product Read Review of The Body Shop Coconut Body Butter Review Summary About the Author Body Shop Coconut Body Butter - Coconut & Moisture Heaven! Oct 06 '04 Author's Product Rating Pros Smells awesome, makes my skin feel and look great, maintains skin, nice consistency Cons Can be oily/tacky if overused, costs $17 for 6.9oz in-store, lid can be slippery The Bottom Line This is an incredibly soothing and moisturizing body butter, with an amazing coconut scent! Full Review Preparing for another brutal winter and implementing a stricter pre-wedding beauty regimen, I browsed in the Body Shop for some products. I soon found the Body Shops Body Butters , which come in a variety of scents. Coconut is a very appealing scent for myself and my fianc, so it didnt take much time to pick it out over the other scents, which include Mango , Nut , Sesame , Shea , Cocoa Butter , Olive , Papaya and Grapeseed . Sample containers were available to try in each kind, so I sniffed a few and tried some on my skin. There are two size containers. There is the smaller 1.7 oz container, which costs $7.00 and the larger 6.9 oz size (which is what I bought, for $17.00 ). (As the saleswoman said in her pitch, You know, the larger size is 4 times larger, for only $10 more!) The containers are brown plastic (corresponding to the coconut scent), with a lid that screws on. There is a picture of a coconut on the top, and the bottom of the container has other information like ingredients and so on. The butter is very thick and is a solid off- white color. When I got my container, it been sitting on the shelf on its side, so when I opened it, the butter had settled to one side. Over time, it shifted back, once it was sitting upright again for a period of time. The butter isnt soft like a lotion but isnt hard like a salve or lip balm it is kind of in between. I can shake the container hard and the butter wont move, but it is soft enough that it doesnt take work to use. To apply, you can just wipe/dip your fingers on it. Like salves and other products, however, it is harder in cooler temperatures and softer in warmer temperatures. The warmth of your skin temperature makes it especially easy to apply, as it melts on. The scent is certainly coconut . It is very reminiscent of a sunscreen. The smell is sweet and warm, and doesnt have a perfumed sort of fragrance. Scoop out with your fingers and massage into your skin, as often as required. My Thoughts & Experiences I love my Burts Bees Hand Salve , but I was also interested to try something else when I was running low. I generally use something on my hands and other dry skin at night, not really caring if it is greasy or thick. The salesperson at the store told me to just use this body butter sparingly, to avoid greasiness, but that I would like this. I like the consistency, which is thick but easy to apply. It is a thick cream, but not hard, and obviously not too liquid. My skin really likes this stuff. I have had no problems with it whatsoever, and no irritation. I use the Body Shop Coconut Body Butter just about every night, and honestly, my hands stay gorgeous. My skin is smooth and feels great, especially considering everything I put them through. Either it is winter dryness, or handling paper and boxes all day at work, or going hiking/camping. The butter provides relief where needed and keeps my hands smooth. The best part is, it really is not greasy. I get a slight tacky-ness if I apply too much, but my skin absorbs the butter pretty well. As for other areas, I use this on my legs, especially my lower legs, where my skin really dries out (I can probably thank my space heater on the floor under my desk at work for that). I try to apply it after shaving, and not only does it feel soothing, it looks great. My skin feels hydrated, not itchy and dry. I have used the Body Shop Coconut Body Butter for problem skin, like after getting some sun (whether or not I burn, I like to moisturize), using lots of cleaning products, or other situations where my skin takes a beating. There are also the usual things that I attend to like dry elbows or knees. My fianc uses it too, and likes it as well. Lastly, I cant go without mentioning the scent . The coconut scent is just dreamy. Scent is supposed to be a strong sense in terms of moods and memories, and the coconut smell really reminds me of sunscreen, and then of course, summers and tropical places. It is a wonderfully pleasant, warm kind of smell. I love using this in the winter, and I count down the days to my honeymoon every night when I put it on! It lingers a little bit, in terms of strength of smell. I can detect a faint bit of coconut in the morning when I get up, and I can smell it a few hours later if I have put any on in the morning. If anything, catching a whiff of it is great. This is great for in the workplace, where I try to avoid perfumed things, or at least those that are heavily fragranced. (Although they are probably wondering why I am wearing sunscreen in February when it is 10 below 0 and we havent seen the sun in 3 months !) Ingredients & NO Animal Testing Water (Solvent/Diluent), Cocos Nucifera (Coconut) Oil (Emollient/Hair Conditioner), Cyclopentasiloxane (Emollient), Butyrospermum Parkii (Shea Butter) (Emollient), Glycerin (Humectant), Theobroma Cacao (Cocoa) Butter (Emollient), Glyceryl Stearate (Emulsifier), PEG-100 Stearate (Surfactant), Cetearyl Alcohol (Emulsifier), Lanolin Alcohol (Stabiliser/Emollient), Phenoxyethanol (Preservative), Fragrance (Fragrance), Methylparaben (Preservative), Propylparaben (Preservative), Xanthan Gum (Viscosity Modifier), Benzyl Alcohol (Preservative), Disodium EDTA (Chelating Agent), Sodium Hydroxide (pH Adjuster), Caramel (Colour). The Body Shop is known for being animal friendly, and not being involved in animal testing. The Body Shop is against animal testing on cosmetic products and ingredients. We do not test our products or ingredients on animals. Nor do we commission others to do so. The container is labeled that this company is Against Animal Testing , and I am glad to see a company that really takes pride in being responsible. I have a really old Body Shop lip balm, and the container says to bring it back to the store when finished, to recycle. I dont see that on my body butter container, but it does have a recycling symbol on the back. Any Downsides? The only issue I have with this item isnt even the butter itself. The only thing I would change is that the lid of the container is wide and has no texture to it, so sometimes after I have applied the body butter, it is hard for me to twist the lid back on or off. Since the larger size butter has a large lid, it is even harder to grasp it. Not a huge deal, but if the lid were at least a little contoured or had texture to it, I would be able to get a better grip. Overall Thoughts Once I tried the Body Shops Coconut Body Butter , I was hooked. I use it almost every night (I forget or am too tired at times!), and it really maintains my skin well. Now that I went with the large size, Im going to buy the smaller size as well, to keep in my desk at work. The Body Shop : http://www.bodyshop.com If you like the Body Shop products, youll probably like Burts Bees!: Burts Beeswax & Banana Hand Crme Burts Bees Royal Jelly Eye Crme Burts Bees Fruit Flavored Lip Gloss Burts Bees Beeswax Lip Balm Burts Bees Lemon Butter Cuticle Creme Burts Bees Carrot Nutritive Night Creme Burts Bees Hand Salve Burts Bees Marshmallow Vanishing Creme Burts Bees Coconut Foot Creme Burts Bees Pore-Refining Mask Burts Bees Almond Milk Hand Creme Dr. Burts Res-Q Ointment Aveeno Daily Moisturizing Lotion Recommended Yes Amount Paid (US$): 17.00 Skin Compatibility: Improved my skin Fragrance: Heavenly scent Skin Compatibility: No problems at all Comments on this Review Read all comments (6) Write your own comment Epinions.com ID: Javelina in Beauty , Home & Garden in Beauty , Home & Garden Location: Long Island & Upstate NY Reviews written: 520 Trusted by: 413 members Back from South America. Happy New Year! View all reviews by Javelina View Javelina's profile Return to top Back to all reviews Featured Resources Additional information on The Body Shop Coconut Body Butter or other products. The Original Body Butter Save up to 75% at The Body Shop. Get free shipping on orders $50+. www.thebodyshop.com Buy Virgin Coconut Oil America's source for coconut oil. Certified Organic top quality oil. tropicaltraditions.com Victoria's Secret Beauty The Official Site. Fragrances, Skin Care, Makeup and more. www.VictoriasSecret.com Body Butter & Skin Care For All New You! Natural Skin Care. Body Butter on Sale. 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AFTER SHAVE Perry EllisCompare Prices and Read Reviews on Perry Ellis After-Shave Fragrances at Epinions.com Join Epinions | Help | Sign In All Categories Beauty Books Business & Technology Cars & Motorsports Computer Hardware Education Electronics Games Gourmet Health Home & Garden Hotels & Travel Kids & Family Magazines & Newspapers Movies Music Musical Equipment Online Stores & Services Outdoor Gear Personal Finance Pets Restaurants & Gourmet Software Sporting Goods ---------------------------------- Related Deals Home > Gifts > Fragrances We found 2 results for Perry Ellis After-Shave Fragrances Search Results Showing 1-2 of 2 items Hide photos Sort by Name or Rating Sort by Price Compare Perry Ellis Perry Man Gift Set - 0.25 oz EDT Spray + 2.0 oz Aftershave Gel + 2.5 oz Hair & Body Wash Perry Ellis · Gift Sets · Men's Cologne · After-Shave Lowest price: $ 22 Compare 360 / PERRY ELLIS MENS 3.4 oz AFTER SHAVE Perry Ellis · After-Shave Showing 1-2 of 2 items Featured Resources FTD.com - Official Site Reserve Valentine's Day Flowers for only $29.99 at FTD.com! www.FTD.COM Local Florists Delivers Great selection of bouquets & more. 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