Understanding Facial Paralysis

Understanding Facial Paralysis

What is a Facial Nerve?

The facial nerve is the seventh cranial nerve with motor, sensory and parasympathetic components. It originates in the brain and passes through the internal ear, and enters the face in front of the ear to supply the muscles of the face. All the movements like the closure of eyes, flaring of nostrils, raising of eyebrows, smiling, pouting, frowning, and other facial expressions are guided by signals from the facial nerve. The facial nerve also gives sensory and parasympathetic fibers to the anterior two-thirds of the tongue. It also has a role in salivation and lacrimation. There are two facial nerves, each supplying half side of the face.

Causes of Facial Palsy

Facial palsy of idiopathic origin and characterized by acute peripheral mononeuropathy is known as Bell’s Palsy. Facial paralysis by viral infection caused by the Herpes Simplex Virus(HSV) is also common. Facial palsy has a rapid onset and develops within 24 to 72 hours. Other causes include infection by Varicella Zoster virus (VZV), Lymes disease, Guillain-Barré syndrome, trauma to the facial nerve, or tumors affecting the facial nerve.

When the facial nerve gets damaged, its function is impaired. It leads to unilateral paralysis of the facial muscles supplied by the nerve and loss of taste function. It is due to the loss of signals from the facial nerve to the facial muscles to function. It leads to affected side facial drooping, drooling, tearing, inability to close the affected eye, and increased sensitivity to sound. Blinking and smiling are also affected. Difficulty with eating, drinking, and speaking has an impact on functioning. Psychologically, anxiety and depression set in, leading to social isolation.

Incomplete recovery leads to chronic facial palsy.

Risk factors of Facial Palsy-

  • Pregnancy, especially during the third trimester.
  • Hypertension
  • Diabetes
  • Immunocompromised person.
  • Genetics

Facial palsy has a good prognosis. 80% recovery occurs within three months. Steroids and anti-viral therapy work well for facial palsy.

Role of Physical Therapy In Facial palsy

  • To initiate the movement by using electrical stimulation.
  • Reeducate the muscle actions and functional retraining.
  • Massage to stimulate the facial muscles.
  • Exercises include passive, active-assisted, and active, depending upon the stage of recovery.
  • Eye protection strategies to manage dry or teary eyes.
  • EMG biofeedback and neuromuscular reeducation.
  • Prescribing alternative tips to assist with eating and drinking.


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