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Facial Palsy

Facial palsy is a common problem that involves the weakness or paralysis of any of the muscles served by the facial nerve, especially those around the eye and to the mouth. The pathway of the facial nerve is long and rather convoluted, so there are a number of causes that may result in facial nerve paralysis.

The most common cause of facial paralysis is Bell's palsy, a condition that causes temporary weakness or paralysis of the muscles in one side of the face.

The symptoms of Bell’s palsy vary from person to person. The weakness on one side of the face can be described as either:

  • partial palsy, which is mild muscle weakness
  • complete palsy, which is no movement at all (paralysis) – although this is very rare

Bell's palsy can also affect the eyelid and mouth, making it difficult to close and open them and in rare cases, it can affect both sides of a person’s face.

Bell's palsy is only diagnosed if other possible causes of these symptoms are ruled out, such as stroke or a tumour.

Bell's palsy is believed to occur when the nerve that controls the muscles in the face becomes compressed. The exact cause is unknown, although it's thought to be because the facial nerve becomes inflamed, possibly due to a viral infection. Variants of the herpes virus may be responsible.

Bell's palsy is a rare condition that affects about 1 in 5,000 people a year. It more commonly affects those aged between 15 and 45, but people outside this age group can also suffer from the condition. Both men and women are affected equally. Bell's palsy is more common in pregnant women and those with diabetes and HIV, for reasons that are not yet fully understood.

Most people notice an improvement in their symptoms after about two to three weeks. However, a complete recovery can take between three and six months. The recovery time varies from person to person and will depend on the amount of nerve damage. Around 7 out of 10 people with Bell's palsy make a complete recovery, with or without treatment.

Steroids, usually prednisolone, are used to reduce the swelling of the facial nerve. Eye drops may be required to prevent problems if the eye is unable to close; tape may also be used to close the eye while sleeping.

Around 3 in 10 people with Bell’s palsy will continue to experience weakness in their facial muscles and 2 in 10 will be left with a more serious long-term problem.

Complications can include speech problems, reduced sense of taste and the permanent tensing of the facial muscles.

In addition to Bell’s palsy, facial paralysis can be caused by:

  • Viral infections such as Ramsay Hunt syndrome.
  • Surgical trauma
  • Lyme disease or following a middle ear infection.
  • Certain neurological conditions.
  • Injury or trauma such as fractures to the brain, skull or face.
  • Trauma during birth: for example caused by forceps or facial presentation delivery.
  • Congenital conditions such as an abnormal development of the facial nerve or muscle in the womb.
  • Rare genetic syndromes such as Moebius syndrome or CHARGE syndrome.
  • Stroke: in a stroke paralysis is caused by brain damage and the messages not being transferred properly to the facial nerve.

Much depends on the cause of a patient's facial paralysis as to which medical treatments will be suitable for them but they may include:

  • Antivirals
  • Botulinum toxin
  • Eye care
  • Pain relief
  • Steroids

Fore more information visit: http://www.facialpalsy.org.uk/

 

 

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