• Rukmani Birla Hospital,Gopalpura Bypass Road, Near Triveni Bridge,Gopalpura,Jaipur – 302018.

WHAT IS FACIAL PALSY? WHAT IS ITS TREATMENT?

Facial palsy, also known as Bell’s palsy is a paralysis or severe weakness of the muscles on one side of the face supplied by facial nerve. Facial palsy affects only one side of the face at a time, making the facial muscles on the affected side to droop and become weak; very rarely does facial palsy affect both sides of the face. This condition is triggered due to viral infusion caused to the facial nerve, also referred to as the ‘seventh carnial nerve’. A person might wake up one morning and realize that one side of the facial muscles is not functioning and this is usually experienced with percutaneous pain. This condition will also impact the saliva, tear production and sense of taste. Facial palsy can affect anyone, and there is no particular reason for it; however, people with diabetes or patients recovering from viral infections are said to be more prone to the problem. A patient affected with facial palsy can completely recover within six months. More so, to some people, facial palsy might appear like a stroke; however, it is not so because, in facial palsy, weakness or paralysis only affects the face, not any other muscle. Cases where the symptoms of facial palsy are not clear, the doctor might conduct some tests to confirm the diagnosis.

Electromyography (EMG): This test is performed to assess the electrical activity of a muscle upon stimulation and the nature and pace of electrical impulses along with nerve activity. An EMG can provide insights into the never damage and also help analyze the severity of the condition and also useful in prognosis

Imaging: Imaging techniques such as MRI or CTI scan are used to eliminate the possibility of other reasons – such as a tumour or skull fracture – for pressure on the facial nerve. 

Causes of Facial Palsy

Facial Palsy occurs when the facial nerve that controls the face muscles is weakened or paralysed. The facial nerve passes through a narrow space in bones from the brain to the face; when this nerve becomes inflamed, it causes pressure on the cheekbone leading to the destruction of the protective covering of the nerve. Once, the cover is distorted, the brain is unable to send signals to the face muscles, causing them to fail and become paralysed or weakened. The exact cause of this condition is unclear; however, it has been strongly linked to the herpes virus that causes the nerve to inflame. Some other viruses that can cause facial palsy are:

  • Chickenpox virus
  • Cold sores and genital herpes virus
  • Mumps virus
  • Influenza B virus

That said, facial palsy can affect both men and women; however, some factors put others at more risk of being affected by this condition. These include:

  • People with migraine
  • People suffering from facial and limb weakness
  • People above 15 and below 60 years of age
  • People with diabetes
  • People with respiratory problems
  • Pregnant women or women who delivered less than a week ago

Symptoms of Facial Palsy

The facial nerve that is impacted during a facial palsy is responsible for all functions of the eye – blinking, opening and closing. It is also in charge for controlling smiling, salivation, frowning and tear production. Moreover, the facial nerve is also connected to the hearing muscles in the ear. Hence, during a facial palsy, any of these functions could be impacted. Some common symptoms of the condition include:

  • Paralysis or weakness on one side of the face
  • Drooping and drooling of/from one side of the face
  • Problem in closing or opening the eye
  • No blinking of the eye causing it to become too dry and irritated
  • Changes in tear production
  • Difficulty in face expressions
  • Alterations in taste
  • Heightened sensitivity to sound
  • Headache

It is important to know and understand the symptoms to seek medical help timely. Facial palsy can be treated successfully, provided proper medical care is received.

Treatment of Facial Palsy

Most patients who have facial palsy tend to recover within two months or maximum within six months of occurrence. Some treatment options that help are:

Prednisolone: This is a hormone that is used to reduce inflammation in the facial nerve; this works by controlling the release of inflammation-causing substances in the body. If given within 72 hours of onset, the steroid can significantly reduce symptoms. This can cause some side effects such as pain in the abdomen, dry skin, dizziness, headache, acne, nausea, indigestion, allergies, etc. – hence it must be taken only after consultation with a certified medical practitioner. Not useful after 2 weeks of symptoms

Lubrication the Eye: This is a method to control the symptom of facial palsy such as loss of blinking which causes the eye to become dry due to evaporation of tears and leads to irritation in the eye. Lubricating the eye with eye drops and ointment helps ease the situation. Eye drops are given to be used upon waking up, and ointment is applied before going to sleep. In cases, where the patient faces problem in closing the eye while sleeping, a surgical tape might be used to keep the eye shut. In case the symptoms get worse, the doctor must be consulted.

Home Care: Facial palsy can also be treated at home upon consultation with the doctor. Some steps, such as below, are very helpful in curing the condition.

  • Face exercises: Once, the medical treatments begin to work, few facial exercises such as tightening and relaxing of the facial muscles can help in providing strength to the facial nerve.Moreover, some exercises to help close the eyes will also be suggested by the doctor to ease symptoms.
  • Dental care: Regular brushing and flossing can help take care of the teeth during a facial palsy when there are high chances of the food building up and causing gum problems.
  • Food: It is advisable to eat soft foods or items easy to chew and digest to avoid difficulty in swallowing and straining the facial nerve even further.

Physical Therapy: Paralysed muscles tend to shorten and shrink, leading to permanent damage. Physical therapy such as massaging of facial muscles can help prevent the possible permanent contractures.

Pain Killers: Some over-the-counter pain killers might prove useful to ease the discomfort and pain caused because of the facial palsy.

Surgery: In severe and rare cases, the doctor might conduct surgery to relieve the pressure of the facial nerve so that it fits well within its bony structure and functions properly. However, the surgery has high risks and complications and hence, is only preferred when all other methods have failed to provide any relief.

That said, facial palsy might appear as a disturbing and threatening condition; however, it can be easily managed and recovered from provided adequate medical help is sought.

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