Facial palsy occurs when the facial nerve (cranial nerve VII) is damaged or inflamed. This results in weakness or paralysis of the muscles on one side (or, in rare cases, both sides) of the face.
It can affect your ability to blink, smile, or move facial muscles, and may also impact speech, eating, and eye protection. While facial palsy can be distressing, treatments and therapies are available to help recovery and improve function.
Symptoms of Facial Palsy
- Sudden or gradual weakness on one side of the face
- Difficulty closing the eye on the affected side
- Drooping of the mouth or eyelid
- Loss of facial expressions, such as smiling or frowning
- Slurred speech or difficulty eating and drinking
- Dry eye or excessive tearing
- Increased sensitivity to sound on the affected side
Causes of Facial Palsy
Common causes include:
- Bell’s Palsy – Sudden facial weakness due to inflammation of the facial nerve, often linked to viral infections.
- Stroke – A stroke affecting the brain can lead to facial muscle weakness.
- Trauma – Injury to the head or face can damage the facial nerve.
- Infections – Lyme disease, herpes simplex virus, or middle ear infections can affect nerve function.
- Surgery or Tumours – Some facial surgeries or tumors can compress or damage the nerve.
- Neurological Conditions – Rare conditions such as Guillain-Barré syndrome or multiple sclerosis can cause facial weakness.
Treatment Options
Treatment depends on the cause and severity of the facial palsy. Options include:
1. Medications
- Steroids (e.g., Prednisolone) – Reduce nerve inflammation, especially for Bell’s Palsy.
- Antiviral Medications – May be prescribed if a viral infection is suspected.
- Pain Relief – Over-the-counter pain relievers for discomfort.
2. Eye Care
- Lubricating Eye Drops/Ointment – Prevents dry eye if blinking is affected.
- Protective Eyewear or Taping at Night – Shields the eye from irritation and injury.
3. Physiotherapy & Exercises
- Facial exercises can strengthen muscles and improve movement.
- Massage and stimulation may help prevent muscle stiffness.
4. Botulinum toxin Injections
In the early stages injections can be given to given to the upper eyelids to protect the eyes
In later stages this can be used to balance or block unintended muscle function
5. Eyelid Surgery
If the difficulty in closing the eyelids remain then surgery may be required to protect the eyes or improve the appearance.
Recovery & Prognosis
- Many cases, especially Bell’s Palsy, improve within 3-6 months.
- Some patients may have residual weakness or synkinesis (unintended muscle movements).
- Ongoing therapy and support can maximize recovery and facial symmetry.
Living with Facial Palsy
- Speech Therapy – Helps with communication challenges.
- Psychological Support – Coping with changes in appearance and function.
- Social Support Groups – Connecting with others facing similar challenges.