What causes Paralysis of the face?

Answer 1

Facial paralysis is a condition defined by the total lack of voluntary muscle movement on at least one side of the face. About 75% of facial paralysis is caused by Bell's Palsy, a condition that causes the nerves in the face to become inflamed. Other common causes of facial paralysis include: * Stroke * Brain Tumor * Sarcoidosis * Lyme disease * Infection * Birth trauma in newborns Doctors will ask patients with facial paralysis questions in order to determine the cause. The patient will be asked about medical history, current symptoms of the facial paralysis, whether any other symptoms are present, and whether the patient has recently been sick or injured. Tests to confirm the cause may include blood tests, MRI, CT scan, and electromyography. A combination of physical, speech, and occupational therapy is generally used. In some cases, plastic surgery is used to improve the ability of the eye to close, as well as to improve appearance.

Answer 2

Definition

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

Alternative Names

Paralysis of the face

Considerations

About 75% of all adult facial paralysis cases are due to Bell's palsy, a condition in which the facial nerve becomes inflamed.

Stroke may cause facial paralysis. When stroke is the cause of facial paralysis, the person may still be able to close the eye on the affected side, as well as wrinkle the forehead. People with Bell's palsy cannot do either of these. With a stroke, other muscles on one side of the body may also be involved.

Facial paralysis due to a brain tumor generally develops slowly and causes headaches, seizures, or hearing loss.

In newborns, facial paralysis may result from birth trauma.

Common Causes

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

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

Call your doctor if you have weakness or numbness in your face. Seek emergency medical help if you experience these symptoms along with a severe headache, seizure, or blindness.

What to expect at your health care provider's office

The doctor will perform a physical exam and ask you questions about your medical history and symptoms, including:

• Are both sides of the face affected?
• Have you recently been sick or injured?
• What other symptoms do you have? For example, drooling, excessive tears from one eye, headaches, seizures, vision problems, weakness, or paralysis.

Tests that may be done include:

• Blood tests, including blood sugar, CBC, ESR, Lyme test
• CT scan of the head
• Electromyography
• MRI of the head

The doctor may refer you to a physical, speech, or occupational therapist. If facial paralysis from Bell's palsy persists for more than 6 - 12 months, plastic surgery may be recommended to improve eye closure and facial appearance.

References

O'Handley JG, Tobin E, Tagge B. Otorhinolaryngology. In: Rakel RE. Textbook of Family Medicine. 7th ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 25.

Stettler B, Pancioli AM. Brain and cranial nerve disorders. In: Marx, JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2006: chap 103.

Answer 3

Definition

Facial paralysis occurs when a person is no longer able to move some or all of the muscles on one side of the face.

Alternative Names

Paralysis of the face

Common Causes

Facial paralysis is almost always caused by:

• Damage or swelling of the facial nerve, which carries signals from the brain to the muscles of the face
• Damage to the area of the brain that sends signals to the muscles of the face

In people who are otherwise healthy, facial paralysis is often due to Bell's palsy, a condition in which the facial nerve becomes inflamed.

Stroke may cause facial paralysis. With a stroke, other muscles on one side of the body may also be involved.

Facial paralysis that is due to a brain tumor usually develops slowly and causes headaches, seizures, or hearing loss.

In newborns, facial paralysis may be caused by trauma during birth.

Other causes include:

• Tumor that presses on the facial nerve
• Infection
• Lyme disease
• Sarcoidosis

Home Care

Treatment depends on the cause. Follow your health care provider's treatment recommendations.

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

Call your health care provider if

Call your doctor if you have weakness or numbness in your face. Seek emergency medical help if you experience these symptoms along with a severe headache, seizure, or blindness.

What to expect at your health care provider's office

The doctor will perform a physical exam and ask you questions about your medical history and symptoms, including:

• Are both sides of your face affected?
• Have you recently been sick or injured?
• What other symptoms do you have? For example, drooling, excessive tears from one eye, headaches, seizures, vision problems, weakness, or paralysis.

Tests that may be done include:

• Blood tests, including blood sugar, CBC, ESR, Lyme test
• CT scan of the head
• Electromyography
• MRI of the head

The doctor may refer you to a physical, speech, or occupational therapist. If facial paralysis from Bell's palsy lasts for more than 6 - 12 months, plastic surgery may be recommended to improve eye closing and the appearance of the face.

References

Rucker JC. Cranioal neuropathies. In: Bradley WG, Daroff RB, Fenichel GM, Jankovic J, eds. Bradley: Neurology in Clinical Practice. 5th ed. Philadelphia, Pa: Butterworth-Heinemann Elsevier;2008:chap 74.

Shy ME. Peripheral neuropathies. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 446.

Reviewed By

Review Date: 02/18/2011

David C. Dugdale III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.