Paralysis of the Face

The condition in which one side of the face experiences total loss of voluntary muscle movement is termed as paralysis of the face. In this condition, the muscles and nerves of the face are affected.

People with facial paralysis experience burning sensation in the eye due to the inability to shut the eyelids. They cannot blink the eyelids, raise the eyebrow, whistle and smile properly. Moreover, males find shaving difficult. Due to inability to control the mouth, drooling of saliva is seen.

Paralysis of the face can be temporary or permanent, depending on the severity. It can be caused by various factors, depending on which the treatment is carried out.

Also known as Idiopathic peripheral facial palsy, Bell's Palsy is a condition in which the facial nerves becomes inflamed. Approximately 75% of facial paralysis in adults is caused by Bell's Palsy, and every year almost 5000 people develop this condition.

Bell's Palsy affects people of all ages, including children, however, is most commonly seen in people between the age of 15-45. The exact reason why this condition is developed is not known, however, it is believed to be conduced by a viral infection affecting the facial nerve.

The virus responsible for cold sores named Herpes simplex is the one behind most of the Bell's Palsy cases. Women who are diabetic or pregnant are prone to be affected by this condition.

Symptoms: Bell's Palsy can come up quickly, sometimes overnight or even after only a few hours. The person experiences weakness in one side of the face, and may also find the eyebrow sagging, due to which closing the eye is not possible.

The eye remains open as the eyelid cannot cover the eye due to paralysis. During sleep, the patient should place a towel or eye pad to prevent unwanted guests from entering. The mouth sags, causing saliva to dribble out of mouth. The lack of control over the mouth makes speaking, drinking, eating very difficult. Some people even experience mild earache.

Treatment: Bell's Palsy is temporary paralysis of the face, and 75% of the patients with Bell's Palsy recover completely from this condition. Recovery time varies from person to person. In some, improvement is seen within 3-8 weeks, whereas, some take 3-6 months to recover.

Few people have muscle tightness, facial twitches and weakness after recovery. Usually Bell's Palsy recovers on its own. However, to enhance the recovery process the doctor may prescribe steroids or antivirals. Surgery is used to correct the long-term effects of the condition. Facial exercises, acupuncture, physiotherapy and massages help enhance recovery.

Partial paralysis can also occur just before or at the time of the baby's delivery. Pressure on the facial nerves (seventh cranial nerve) before or during the delivery process can result in loss of voluntary muscle movement on the baby's face.

There is no way one can prevent facial paralysis from occurring, as the root cause of why this happens is still unknown. However, it is believed that a difficult delivery process (long labor process), may conduce this condition.

Diabetic women are usually seen to give birth to larger babies. The large size may lead to birth trauma. Use of epidural anesthesia or medications to conduce labor and stronger contractions.

Symptoms: Generally birth trauma resulting in paralysis of the face involves the lower part of the facial nerve. The lower region of the nerve controls the muscles around the lips, which is why the defect is observed mostly when the baby cries.

The eyelid on the affected side may not close. Moreover, while crying, the part of the face below the eyes will appear uneven, wherein the mouth will not move in the same manner on both sides of the face.

Treatment: Most of the time, this condition goes away on its own. However, special therapy is required for infants with permanent paralysis.

Miscellaneous Causes: Sarcoidosis, a disease involving the inflammation of the lymph nodes, liver, skin, lungs, eyes and other tissues can also result in paralysis of the face. Lyme disease, spread by tick bites is also another disease that can cause facial paralysis.

Besides these diseases, various other infections can also cause paralysis. Brain tumor can also lead to this condition, however, the paralysis will develop gradually, and will be accompanied by seizures, headaches or hearing loss.

Another cause for paralysis is stroke. However, facial paralysis caused by a stroke, the patient will be able to close the eye on the affected side. The patient will also be able to frown. Traumatic injury occurred during surgeries such as benign parotid tumor surgery, facelift surgery, tympanomastoid (ear) surgery, etc. can also be the reason for paralysis.

Depending on the underlying cause of facial paralysis, the treatment will be decided. The patient may have to undergo lyme test and blood tests. An MRI (Magnetic Resonance Imaging) scan may also be required to check for signs related to a brain tumor or a stroke.

A CT scan of the head or Electromyography (a technique of evaluating and recording the activation signal of muscles) may also be done. Sometimes surgery is required to repair the injured nerve.

Plastic surgery is conducted to improve the appearance of the face and improve the eye's ability to see (permanent paralysis of the face). A combination of speech, occupational and physical therapy is used to enhance recovery.

The facial distortion improves as time progresses, however, permanent paralysis is seen in about 20% of the cases. Older people are less likely to completely recover from this condition.