Facial palsy, also called Bell’s palsy is a paralysis or weakness on one side of the face that tends to occur suddenly. It is a temporary weakness of the facial muscles that makes half of the face to appear droopy and it can occur at any age. The weakness may also affect tear and saliva production, as well as the sense of taste.

Another name for facial palsy is Acute Peripheral facial palsy of unknown cause. Although the exact cause is unknown, it is believed to occur when the nerve that controls the facial muscle becomes swollen, inflamed, or compressed.

Causes of Facial Palsy

The facial nerve is responsible for controlling majority of the facial muscles and parts of the ear. The facial nerve passes through a gap of bone from the brain to the face. If this facial nerve becomes inflamed it may pinch in the narrow gap or press against the cheek bone resulting in the damage of the protective covering of the nerve. This prohibits proper transmission of signals that travel from the brain to the facial muscles leading to paralysis or weakening of the facial muscles.

What causes this damage is unknown, but it is believed to be most likely triggered by a viral infection.

The viruses that have been linked to facial palsy include viruses that cause:

• Herpes simplex which is responsible for genital herpes and cold sores
• Herpes zoster virus which causes shingles and chicken pox
• Sarcoidosis which causes organ inflammation
• Lyme disease, a bacterial infection caused by infected ticks
• Epstein-Barr virus, which causes mononucleosis
• HIV, damages to the immune system
• Adenovirus, causes respiratory illnesses
• Rubella, German measles
• Coxsackievirus, hand and foot diseases

Symptoms of Facial Palsy

The symptoms of facial palsy tend to appear suddenly and you may notice them when you wake up in the morning. The symptoms include:

• Rapid onset of facial droop/weakness/paralysis on one side of the face
• Drooling
• Inability to make facial expressions such as frowning or smiling
• Difficulty drinking and eating
• Muscle twitches in the face
• Difficulty opening or closing the eye
• Dry mouth and eye
• Sound sensitivity
• Headache
• Loss of taste
• Eye irritation on the involved side

Risk Factors of Facial Palsy

You are a higher risk of developing facial palsy if you:

• Are diabetic
• Are pregnant
• Have a family history of this condition
• Have a lung infection

Diagnosis of Facial Palsy

Diagnosing facial palsy will start by your physician asking about your symptoms including when you started noticing them. He/she will then perform a physical examination which will include asking you to move your facial muscles by lifting your brows, closing your eyes, frowning, smiling, and many others.

A variety of tests will then be done to diagnose facial palsy including blood tests to check for viral or bacterial infection. If the cause of the symptoms are not clear, other imaging tests may be done which include:

• Imaging scans: MRI and CT scans to check possible sources of pressure on the facial nerve such as skull fracture or tumor.
• Electromyography (EMG): This confirms the presence of nerve damage and its severity.

Treatment of Facial Palsy

There’s no specific treatment for facial palsy as most individuals recover without any treatment. However, it may take several weeks or months for the facial muscles to fully regain their strength. Your physician may recommend one of the following treatments to help with your recovery:

• Medication
• Corticosteroids to reduce inflammation
• Antibacterial or antiviral medication if the facial palsy was caused by bacteria or virus
• Eye drops
• Over-the-counter pain medication to help with the pain
• Physical therapy to help prevent facial muscles from shrinking and shortening which can lead to permanent contractures.
• Surgery such as facial reanimation to help restore facial movement and correct facial symmetry from lasting facial problems.

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