Definition

Facial paralysis occurs when a person is no longer able to move some or all of the muscles on one side of the face.

Common Causes

Facial paralysis is almost always caused by:

• Damage or swelling of the facial nerve, which carries signals from the brain to the muscles of the face
• Damage to the area of the brain that sends signals to the muscles of the face

In people who are otherwise healthy, facial paralysis is often due to Bell's palsy, a condition in which the facial nerve becomes inflamed.

Stroke may cause facial paralysis. With a stroke, other muscles on one side of the body may also be involved.

Facial paralysis that is due to a brain tumor usually develops slowly and causes headaches, seizures, or hearing loss.

In newborns, facial paralysis may be caused by trauma during birth.

Other causes include:

• Tumor that presses on the facial nerve
• Infection
• Lyme disease
• Sarcoidosis

Home Care

Treatment depends on the cause. Follow your health care provider's treatment recommendations.

If the eye cannot fully close, the cornea must be protected from drying out with prescription eye drops or gel.

Call your health care provider if

Call your doctor if you have weakness or numbness in your face. Seek emergency medical help if you experience these symptoms along with a severe headache, seizure, or blindness.

What to expect at your health care provider's office

The doctor will perform a physical exam and ask you questions about your medical history and symptoms, including:

• Are both sides of your face affected?
• Have you recently been sick or injured?
• What other symptoms do you have? For example, drooling, excessive tears from one eye, headaches, seizures, vision problems, weakness, or paralysis.

Tests that may be done include:

• Blood tests, including blood sugar, CBC, ESR, Lyme test
• CT scan of the head
• Electromyography
• MRI of the head

The doctor may refer you to a physical, speech, or occupational therapist. If facial paralysis from Bell's palsy lasts for more than 6 - 12 months, plastic surgery may be recommended to improve eye closing and the appearance of the face.

References

Rucker JC. Cranioal neuropathies. In: Bradley WG, Daroff RB, Fenichel GM, Jankovic J, eds. Bradley: Neurology in Clinical Practice. 5th ed. Philadelphia, Pa: Butterworth-Heinemann Elsevier;2008:chap 74.

Shy ME. Peripheral neuropathies. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 446.