Facial nerve palsy

Face | Neurology | Facial nerve palsy (Disease)


Facial nerve paralysis is a common problem that involves the paralysis of any structures innervated by the facial nerve. The pathway of the facial nerve is long and relatively convoluted, and so there are a number of causes that may result in facial nerve paralysis. The most common is Bells palsy, an idiopathic disease that may only be diagnosed by exclusion. Sometimes the symptoms are recurrent and rarely the weakness persists for life. The cause of this disorder is felt to be a viral infection (herpes simplex or zoster, Ebstein Barr or cytomegalovirus).

Common symptoms of Bells palsy include one-sided facial drooping, inability to smile on one side, inability to close the eye on one side, and inability to raise the eyebrow on one side. Other symptoms may include eye pain, drooling, and increased sensitivity to loud noises.

Causes and Risk factors

Bells palsy is an inflammation of the facial nerve resulting in a gradual or sudden onset of paralysis or weakness on one side of the face. The disease most often occurs in patients between the ages of 15 and 60. The majority of patients experience a full recovery in 3 to 6 months. Bells palsy is usually a self-limiting, non-life threatening condition that spontaneously remits within six weeks. The incidence is 15-40 new cases per 100,000 people per year.

There is no predominant age or racial predilection; however it is 3. 3 times more common during pregnancy and slightly more common in menstruating females. In general, the incidence increases with advancing age.

Diagnosis and Treatment

An examination will show facial drooping on one side of the face or just on the forehead, eyelid, or mouth. Examination of the eardrum may show fluid-filled sacs (vesicles).

Finding and treating the cause (if it can be found) may relieve symptoms in some cases. The disorder may disappear on its own depending on the severity of nerve damage. Powerful anti-inflammatory drugs (steroids) may be used if the condition is caught early enough. The drugs may be used in combination with an antiviral drug called acyclovir. ...