Facial paralysis occurs when a person is no longer able to move some or all of the muscles on one side of the face.

Paralysis of the face

Facial paralysis is almost always caused by:

• Damage or swelling of the facial nerve, which carries signals from the brain to the muscles of the face
• Damage to the area of the brain that sends signals to the muscles of the face

In people who are otherwise healthy, facial paralysis is often due to Bell's palsy. This is a condition in which the facial nerve becomes inflamed.

Stroke may cause facial paralysis. With a stroke, other muscles on one side of the body may also be involved.

Facial paralysis that is due to a brain tumor usually develops slowly. Symptoms can include headaches, seizures, or hearing loss.

In newborns, facial paralysis may be caused by trauma during birth.

Other causes include:

• Infection of the brain or surrounding tissues
• Lyme disease
• Sarcoidosis
• Tumor that presses on the facial nerve

The doctor will perform a physical exam and ask questions about your medical history and symptoms, including:

• Are both sides of your face affected?
• Have you recently been sick or injured?
• What other symptoms do you have? For example, drooling, excessive tears from one eye, headaches, seizures, vision problems, weakness, or paralysis.

Tests that may be ordered include:

• Blood tests, including blood sugar, CBC, ESR, Lyme test
• CT scan of the head
• Electromyography
• MRI of the head

The doctor may refer you to a physical, speech, or occupational therapist. If facial paralysis from Bell's palsy lasts for more than 6 - 12 months, plastic surgery may be recommended to help the eye close and improve the appearance of the face.

Follow your health care provider's instructions on how to take care of yourself at home. Take any medicines as directed.

If the eye cannot fully close, the cornea must be protected from drying out with prescription eye drops or gel.

Call your doctor if you have weakness or numbness in your face. Seek emergency medical help right away if you have these symptoms along with a severe headache, seizure, or blindness.

Griggs RC, Jozefowicz RF, Aminoff MJ. Approach to the patient with neurologic disease. In: Goldman L, Schafer AI, eds. Goldman’s Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 403.

Shy ME. Peripheral neuropathies. In: Goldman L, Schafer AI, eds. Goldman’s Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 428.