Facial Palsy

  • What is facial palsy?
  • A facial palsy is when you have weakness of your facial muscles, usually on one side of the face only. It is fairly common, generally comes on suddenly and is usually temporary.
  • What are the causes?
  • Although in most cases of facial palsy a cause may never be found, (so-called Bell’s palsy or idiopathic palsy) there are some known causes for example a viral infection of the nerves supplying the face, such as herpes zoster (Shingles) and herpes simplex (the cold sore virus). Pressure on the facial nerve from a tumor or injury to the nerve can also cause weakness. other damage to this nerve.
  • What to look for: the symptoms of facial palsy
  • Drooping eyebrow
  • Difficulty closing the eye
  • Dryness or watering of the eye on the affected side
  • Drooping mouth
  • Dribbling of saliva and drinks
  • Difficulty in speaking
  • A change in or loss of taste at the front of the tongue
  • How is it diagnosed?
  • Your doctor will be able to confirm you have a facial palsy by talking to you and examining the muscles and nerves of your face. You may be asked to have a blood test if infection is suspected. Other possible tests may include a hearing test or a head scan if your doctor suspects other possible causes for your symptoms.
  • What can be done?
  • The majority of people who experience a facial palsy will recover over time without any treatment. However, if the symptoms are recognized early, the doctor may start you on a short course of steroids (e.g. Prednisolone) to help decrease the swelling around the facial nerve and increase the chances of a speedy full recovery. If a viral infection is a suspected cause of your facial palsy then a course of anti-viral medication will be needed.
  • If the eye is affected by facial palsy, eye care is vital to avoid further complications such as scratches to the front of the eye. It is advisable to regularly apply some artificial tear
    drops in the eye during the day and a special lubricating ointment at night. In addition, if you are unable to close your eye properly, it is advisable to tape the eye closed at night time. Regular daily facial exercises can also be used to help re-strengthen the muscles of the face and again increase your chances of a good recovery.
  • Prognosis
  • Seventy five percent of the people with a facial palsy make full recovery within 4-6 weeks. The rate of recovery is influenced by the cause of the facial palsy and your doctor will be able to give you an idea of your rate of recovery. On the whole, most people see a significant improvement within 3-6 months. If, after 6 months the facial palsy remains, some people may go on to make a little progress over time, but others may be left with the palsy.
  • What is the role of surgery in facial palsy?
  • In some select patients depending of the cause and the duration of the facial weakness, facial nerve decompression surgery gives excellent results with complete recovery of the nerve function.