Facial nerve is seventh cranial nerve, originating from the brain. Branches of facial nerve innervate muscles of face and neck. Damage to facial nerve leads to facial paralysis, which is characterized by loss of facial movement. Expression of mood and emotions, chewing, speech etc depends on movement of facial muscles. In facial paralysis the movement of facial muscles in affected thus these patients find difficulty in chewing, speaking, or expressing their emotions.
Facial paralysis occurs when the facial nerve is damaged due to infection and inflammation, injury on head, or when a tumor in head compresses facial nerve. One of the most common causes of facial nerve paralysis is Bell’s palsy, a condition caused by viral infection where one side of face is paralyzed.
Fortunately Bell’s palsy heals within 3 to 4 months. However, paralysis may last for a long period in certain condition such as after a stroke attack. Medication, physiotherapy, massage, corrective surgery helps to minimize effect of facial paralysis.
Common Causes Of Facial Paralysis
Facial nerve paralysis as mentioned before occurs due to damage to facial nerve.
One of the most common causes of facial paralysis is Bell’s palsy. No one knows the exact etiology of Bell’s palsy, but viral infection is suspected to be the reason. The condition causes paralysis of one side of face with drooping of eyelids and jaw. Fortunately patients with symptoms of Bell’s palsy recover within 3 to 6 months.
Facial paralysis in child can develop during child birth. Forceps delivery, high birth weight, first pregnancy, etc are factors that may be responsible for facial paralysis in child. Prognosis in such case is good and most children recover from facial nerve dysfunction.
Other factors that may cause facial paralysis are:
- Tumor in head
- Fracture of skull
- Lyme disease
- Middle ear bacterial infection.
- Stroke may lead to facial paralysis, although it may not be directly related to facial nerve. The damage results in brain and messages transmission to the nerve may be hampered.
- Patients suffering from Sarcoidosis, Multiple sclerosis, Guillain-Barre syndrome may sometimes develop facial paralysis.
Signs And Symptoms Of Facial Paralysis
The onset of symptoms of facial paralysis may be sudden as in case of Bell’s palsy or may take some time to develop as in case of tumor. Facial paralysis affects a person’s quality of life. Patient often feels low self esteemed and embarrassed due to change in contour of face caused due to weakness of facial muscles. Following symptoms may develop in facial paralysis:
- Usually one side of face is paralyzed. It does not produce weakness in arms and legs. However, in stroke along with facial paralysis there may be associated weakness in arm and leg on one side.
- Facial nerve supplies muscles of eyes, eyebrows, mouth, cheek and chin. Due to disruption of impulses, face may appear flat on one side with loss of proper movement.
- Drooping of eyelids.
- Dryness in the eyes.
- Unable to close the eyes.
- Corner of mouth is pulled down. Patient is unable to smile on the affected side.
- Difficulty in eating and drinking.
- Drooling of saliva from corner of mouth.
- Difficulty in speaking due to weakness in lips and cheek.
- Loss of wrinkles from forehead.
Treatment Options For Facial Paralysis
Treatment of facial paralysis depends on the underlying cause. Majority cases of facial paralysis are those of Bell’s palsy. The symptoms of Bell’s palsy subside within 3 to 6 months even without treatment. Some physicians suggest taking corticosteroids and antiviral medications for a short period of time.
- During the period of recovery, eye care is extremely important part of treatment since the patient is unable to close his eye completely even while sleeping. Eye patch during night, wearing sunglasses in sunlight or in outdoor places is beneficial. Also use of moisturizing eye drops and eye ointment will prevent dryness in the eyes.
- Heat therapy is beneficial. Apply warm packs as it will help in relieving inflammation and pain. Heat therapy is useful for patients who suffer from pain at the back of ears.
- Massage after the heat therapy session improves circulation of blood in the muscles.
- Physical therapy as suggested by physiotherapist is effective in recovery. It helps to stimulate the damaged nerve and improve the tone and strength of facial muscles.
- If the underlying cause is tumor, surgical excision of tumor will help to improve the condition.