Paralysis of the face

Alternative names
Facial paralysis

Definition
Facial paralysis is the total loss of voluntary muscle movement of one side of the face.

Considerations
Facial paralysis in adults is often due to Bell’s palsy. This disorder (probably derived from a virus) usually affects one side of the face causing a drooping mouth, drooling, and excessive tearing from one eye. While the facial distortion usually improves over time, there may be some permanent deformity. Sometimes there is loss of taste on the affected side of the face. Sound may also be louder on the affected side.

In facial paralysis due to stroke, the eye on the affected side can be closed and the forehead can be wrinkled. This is not possible with Bell’s palsy. Other muscles on one side of the body may also be involved with a stroke.

Facial paralysis due to a brain tumor generally develops gradually with accompanying headaches, seizures, or hearing loss.

In newborns, facial paralysis may result from birth trauma.

Common Causes

     
  • Bell’s palsy  
  • Stroke  
  • Brain tumor  
  • Sarcoidosis  
  • Lyme disease  
  • Infection  
  • Birth trauma (newborns)

Home Care
Treatment depends on the cause. Follow your health care provider’s treatment recommendations. Sometimes steroids and acyclovir may be given depending on the cause.

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

Call your health care provider if

     
  • There is any facial paralysis. If it is accompanied by a severe headache, seizure, or blindness it may be an emergency situation!  
  • The muscles in the body are involved.

What to expect at your health care provider’s office
The medical history will be obtained and a physical examination performed.

Medical history questions documenting facial paralysis in detail include:

     
  • Are both sides of the face affected?  
  • Is there any recent history of illness or injury?  
  • What other symptoms are also present?       o Is there a facial droop?       o Is there drooling?       o Are there excessive tears from one eye?       o Are there headaches?       o Are there seizures?       o Are there any vision problems?       o Is there weakness or paralysis elsewhere in the body?

The physical examination will include a detailed neurological examination.

DIAGNOSTIC TESTS that may be performed include:

     
  • Blood studies such as a CBC, ESR, Lyme test  
  • MRI of the head  
  • CT scan of the head  
  • Electromyography

Intervention:
Arrangements may be made for physical therapy, speech therapy, or occupational therapy, if appropriate.

If facial paralysis from Bell’s palsy persists for greater than 6 to 12 months, plastic surgery may be recommended to improve eye closure and facial appearance.

After seeing your health care provider:
You may want to add a diagnosis related to facial paralysis to your personal medical record.

Johns Hopkins patient information

Last revised: December 8, 2012
by Armen E. Martirosyan, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.