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Facial paralysis

Paralysis of the face

 

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

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 palsy . This is 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. Symptoms can include headaches, seizures, or hearing loss.

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

Other causes include:

  • Infection of the brain or surrounding tissues
  • Lyme disease
  • Sarcoidosis
  • Tumor that presses on the facial nerve

 

Home Care

 

Follow your health care provider's instructions on how to take care of yourself at home. Take any medicines as directed.

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

 

When to Contact a Medical Professional

 

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

 

What to Expect at Your Office Visit

 

The health care provider will perform a physical exam and ask 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 ordered include:

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

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

The health care provider may refer you to a physical, speech, or occupational therapist. If facial paralysis from Bell palsy lasts for more than 6 to 12 months, plastic surgery may be recommended to help the eye close and improve the appearance of the face.

 

 

References

Griggs RC, Jozefowicz RF, Aminoff MJ. Approach to the patient with neurologic disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 403.

Shy ME. Peripheral neuropathies. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 428.

 
  • Ptosis, drooping of the eyelid - illustration

    Drooping of the eyelid is called ptosis. Ptosis may result from damage to the nerve that controls the muscles of the eyelid, problems with the muscle strength (as in myasthenia gravis), or from swelling of the lid.

    Ptosis, drooping of the eyelid

    illustration

  • Facial drooping - illustration

    Facial drooping can be caused by a disorder such as Bell's palsy. This disorder is a mononeuropathy (involvement of a single nerve) that damages the seventh cranial (facial) nerve. The facial nerve controls movement of the muscles of the face.

    Facial drooping

    illustration

    • Ptosis, drooping of the eyelid - illustration

      Drooping of the eyelid is called ptosis. Ptosis may result from damage to the nerve that controls the muscles of the eyelid, problems with the muscle strength (as in myasthenia gravis), or from swelling of the lid.

      Ptosis, drooping of the eyelid

      illustration

    • Facial drooping - illustration

      Facial drooping can be caused by a disorder such as Bell's palsy. This disorder is a mononeuropathy (involvement of a single nerve) that damages the seventh cranial (facial) nerve. The facial nerve controls movement of the muscles of the face.

      Facial drooping

      illustration

    A Closer Look

     

    Tests for Facial paralysis

     

       

      Review Date: 1/31/2015

      Reviewed By: Linda J. Vorvick, MD, medical director and director of didactic curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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