Symptoms and Causes of Facial Nerve Palsy

Facial nerve palsy, or facial paralysis, occurs when there is damage to the facial nerve, which innervates the muscles of the face. This can be caused by pressure on the facial nerve, injury, or other etiologies resulting in symptoms such as asymmetry of the face, weakened facial muscles, inability to express emotion (smiling, frowning).

There are numerous possible causes for facial paralysis, necessitating a range of testing and a full patient history and physical exam to delineate the specific cause for effective treatment. Possible causes of facial nerve palsy include:

  • Infection - Bell's palsy (herpes simplex virus), Ramsay Hunt Syndrome, Lyme disease.
  • Diabetes
  • Stroke
  • Autoimmune Disease – Sarcoidosis
  • Congenital – Improperly developed or absent facial nerves, or developmental abnormalities. Facial palsy is present at birth rather than acquired after or during childbirth.

Facial Nerve Palsy Treatment

Treatment for facial palsy includes both medical and surgical options. Medical treatment is indicated for infectious causes and consists of administering corticosteroids (Prednisone) and antiviral agents (valacyclovir).

Surgical treatment of facial palsy is necessary only when medical treatment does not result in full recovery.

It is imperative that protection of the cornea be a priority when control of the eyelids is lost or impaired. Lack of tears and exposure to light can lead to corneal damage. Isotonic saline solution, natural tears and eye patch or tape should be used to facilitate closing of the eye, particularly during sleep. In some cases, a platinum eyelid weight may be placed to augment the eye closure.

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