What is Facial Nerve Paralysis and Treatments?
BDS (Bachelor of Dental Surgery), 10 years of experience
What is the meaning of Facial Nerve Paralysis?
The loss of facial movement due to nerve damage is known as facial nerve paralysis.
The facial muscles may become weak or droop due to facial nerve paralysis. It leads to an inability to move the muscles that control blinking, smiling, and other facial movements. This condition can occur on one or both sides of the face.
Facial nerve paralysis can occur suddenly like Bell’s palsy, or happen gradually over a period of some months like a neck or head tumor.
The facial nerve paralysis may last for a short or long period of time depending on its cause.
In today’s article, we will be discussing in detail about facial nerve paralysis and its treatment.
- What are the causes of Facial Nerve Paralysis?
- What are the risk factors for Facial Nerve Paralysis?
- What are the symptoms of Facial Nerve Paralysis?
- How to diagnose Facial Nerve Paralysis?
- What are the various Facial Nerve Paralysis Treatments?
- What are the complications of Facial Nerve Paralysis?
- What is the cost of Facial Nerve Paralysis Treatment in India?
What are the causes of Facial Nerve Paralysis?
The various causes of facial nerve paralysis include:
- Bell’s palsy: This is a condition that causes inflammation of the facial nerve, leading to the drooping of the muscles on one side of the face. It is the most common cause of facial nerve paralysis. The exact cause of Bell’s palsy is not known. It could be related to a viral infection of the facial nerve. In most cases, recovery occurs within six months.
- Stroke: This is a serious condition that leads to facial nerve paralysis due to the damage to the nerves controlling the facial muscles in the brain. Damage to the cells of the brain is caused due to lack of oxygen or excessive pressure on the brain cells caused by bleeding. This can cause the death of the brain cells within minutes.
- Other causes: The other causes of facial nerve paralysis include:
- Injury to the face
- Skull fracture
- Neck or head tumor
- Infection of the middle ear
- Ear damage
- Lyme disease (a bacterial disease that is transmitted to humans by tick bites)
- Autoimmune diseases (when the body’s immune system attacks the healthy tissues and organs of the body), like multiple sclerosis (affecting the brain and spinal cord) and Guillain-Barre syndrome (affecting the nervous system)
- Ramsay-Hunt Syndrome (a viral reactivation affecting the facial nerve)
- At birth due to congenital syndromes like Melkerrson-Rosenthal syndrome (a rare neurological condition) and Moebius syndrome (a condition characterized underdevelopment of the facial nerves)
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What are the risk factors for Facial Nerve Paralysis?
Certain factors may increase the risk of developing facial nerve paralysis and may include:
- Diabetes
- Upper respiratory tract infection, like cold or flu
- Pregnancy, especially the third trimester
- Autoimmune diseases
- Family history of Bell’s palsy or stroke
- Cold sores (infection due to the herpes simplex virus around the border of the lips)
- High blood pressure
- Mononucleosis (infection caused due to Epstein-Barr virus which is transmitted by saliva)
- Shingles (caused due to the herpes zoster virus leading to the reactivation of the chickenpox in the body and a painful rash)
( Know more about- What is Diabetes? What are the types of Diabetes? )
What are the symptoms of Facial Nerve Paralysis?
The symptoms of Bell’s palsy include:
- Facial paralysis, usually on one side of the face
- Decrease in tearing
- Loss of control in blinking on the affected side
- Mouth drooping to the affected side
- Slurred speech
- Altered sense of taste
- Drooling
- Difficulty in drinking or eating
- Pain in or behind the ear
- Hypersensitivity to sound on the affected side
In case of a stroke, the following additional symptoms can also be seen:
- Confusion
- Dizziness
- Changes in the level of consciousness
- Seizures
- Changes in vision
- Loss of coordination
- Weakness in the legs or arms on one side of the body
In case of a stroke, the person is usually able to blink willingly and move his/her forehead to the affected side, unlike Bell’s palsy.
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How to diagnose Facial Nerve Paralysis?
- Physical examination: The doctor will check you physically. The doctor may ask you to try and move your facial muscles, such as smiling, frowning, closing the affected eye, and lifting the eyebrow. Discuss all your symptoms with the doctor. Inform your doctor about your medical history and family history.
- Electromyography (EMG): This test helps in confirming the presence of nerve damage, and determines the severity of the damage. It measures the electrical activity of a muscle in response to stimulation and the speed and nature of the conduction of the electrical impulses along a nerve.
- Imaging tests: Imaging tests like MRI scans or CT scans may be recommended to view the internal structures of the face and rule out other possible causes of pressure on the facial nerve, like a skull fracture or tumor.
- Blood tests: These tests may be recommended to check for any underlying medical condition that may be causing facial nerve paralysis.
What are the various Facial Nerve Paralysis Treatments?
The different types of treatments done depend on the cause of facial nerve paralysis, age of the patient, the severity of the condition, and duration of symptoms. The different types of treatments include:
Medications:
- Bell’s palsy can be treated by oral corticosteroids like prednisone, which is usually given within 72 hours of the onset of the condition.
- The corticosteroids can be given with certain antiviral medications for the treatment of Bell’s palsy.
Physiotherapy:
- A physiotherapist helps you to massage and exercise your facial muscles.
- This prevents the shrinking and shortening of the paralyzed muscles which may cause permanent contractures.
( Know more about- What is Physiotherapy? )
Surgeries:
- Nerve graft or direct reanastomosis: The surgeon stitches (sutures) together the severed end of the damaged nerves in this procedure. If it is not possible to stitch the ends of the nerves directly, a piece of a nerve is harvested and used as a graft or connector between the two ends of the nerves.
- Eyelid procedures: The upper-lid weighting operations and lower-lid tightening procedures are used for the treatment of eye conditions. Gold or platinum weights may be implanted under the upper eyelid skin to allow the closure of the lid passively with gravity.
- Temporalis tendon transfer: The temporalis tendon connects the temple to the jaw and can be felt on touching when clenching the jaw. Transfer of the jaw tendon to the corner of the mouth can help in restoring the movement of the lips without any alteration to the shape of the face.
- 12-7 or 5-7 Nerve graft: The hypoglossal nerve (a nerve leading to the tongue) is connected to a facial nerve to produce nerve growth of the muscles of the face. This procedure can be performed within the first two years of an injury to the nerve for maintaining the facial tone and regaining some of its lost function.
- Contour restoration: This procedure involves the transfer of fat and tissue from the thighs, known as an anterolateral thigh free flap, used for the restoration of the normal facial appearance. This type of flap is known as microvascular reconstruction.
- Botox injections: Botulinum toxin or botox injections can help in treating the voluntary and involuntary muscle movements that may occur during the various treatments done for restoring nerve function and growth. This can help in restoring facial symmetry.
( Know more about- What is Botox Treatment? )
What are the complications of Facial Nerve Paralysis?
The complications of facial nerve paralysis are:
- Irreversible damage to the facial nerve
- Excessive drying of the cornea (clear protective covering) of the eye
- Partial or complete eye blindness
- Abnormal regrowth of nerve fibers causing involuntary contraction of muscles while trying to move other muscles (called synkinesis), for example, the eye on the affected side may close involuntarily when you smile
( Know more about- What is Speech Therapy? )
What is the cost of Facial Nerve Paralysis Treatment in India?
The total cost of facial nerve paralysis treatments in India can range from around INR 65,000 to INR 1,20,000, depending on the type of treatment done. However, many prominent hospital doctors in India specialize in facial nerve paralysis treatments. But the cost varies across different hospitals.
If you are coming from abroad, apart from the cost of facial nerve paralysis treatments, there will be an additional cost of living in a hotel and the cost of local travel. So, total cost of facial nerve paralysis treatments in India comes to a total of INR 85,000 to INR 1,56,000.
We hope that we could answer all your questions regarding facial nerve paralysis and its treatments through this article.
If you need more information and treatment about facial nerve paralysis, you can contact a Neurologist.
We only aim to provide you with information through this article. We do not recommend any medication or treatment to anyone. Only a qualified doctor can give you the best advice and correct treatment plan.
