The Facial palsy generally Means weakness of the facial muscles, mainly resulting from temporary or/and permanent damage to the facial nerve.
When a facial nerve is either non-functioning or missing, the muscles in the face do not receive the necessary signals in order to function properly. This results in paralysis of the affected part of the face, which can affect movement of the eye(s) and/or the mouth, as well as other areas.
There are different degrees of facial Palsy : sometimes only the lower half of the face is affected Mainly In stroke , sometimes one whole side of the face is affected Mainly when facial nerve is affected & in some cases both sides of the face are affected.
Facial nerves Detail:
Each side of the face has its own facial nerve, so damaging the left facial nerve will affect the left side of the face, & Right Side Of Damage Will affect Right Side. Each nerve starts at the brain & enters the face to the front of the ear where it then divides into five Different branches. All These branches supply the muscles of face. Tears, saliva production and taste are also controlled by the facial nerve in different ways.
causes facial palsy :
The most commonly known cause of facial paralysis is Bell’s palsy, there are actually many different causes of facial palsy, and treatment and prognosis vary greatly depending on the cause. Some of the main causes of facial palsy are listed below:
Viral infections such as Bell’s palsy & Ramsay Hunt syndrome.
Surgical causes: Eg. during removal of acoustic neuroma or facial nerve tumour Removal, or when operating on the parotid gland.
Bacterial causes such as Lymph disease or a middle ear infection.
Neurological conditions such as Neurofibromatosis 2, or GBS (Guillain-Barré syndrome.)
Traumatic injury such as fractures to the brain, skull or face.
Birth trauma: Eg. caused by forceps or facial presentation delivery.
Congenital conditions such as an abnormal development of the facial nerve or muscle in the womb.
Rare genetic syndromes such as Moebius syndrome or CHARGE syndrome.
Stroke: Facial Nerve is not affected But from cerebral damage.
Classification of facial nerve injuries :
Three different kinds of facial nerve injury:
First degree injury – when the facial nerve is just concussed or bruised and recovers within eight weeks.
Second degree injury – where the facial nerve is more damaged but still retains its outer layer. The nerve begins to show the first signs of recovery at about four months as it slowly repairs.
Third degree injury – when the facial nerve is more severely damaged, any recovery is much slower and always incomplete. Sometimes the nerve is completely severed & surgical repair is needed to restore facial function.
Functions facial muscles ;
Raising the eyebrows (frontalis)
Closing the eyes (orbicularis oculi)
Open mouth smiling (zygomaticus)
Closed mouth smiling (risorius)
Pouting (orbicularis oris)
Lifting top lip (levator labii)
Pulling lower lip down (depressor labii)
Sticking bottom lip out (mentalis)
Pulling jaw and corners of mouth gently down (platysma)
Wrinkling nose (procerus/nasalis)
Symptoms of Facial Palsy :
Facial palsy Mainly affects only one side of the face although in rare cases it may affect both sides.
A complete facial palsy on one side of the face affects the brow, eye, cheek and mouth. This means the facial nerve signals that control movement in these muscles are not working. The face may appear flattened & movement may be lost.
Symptoms may improve or worsen over time depending on the type and degree of facial nerve damage and the cause of your facial palsy.
Some types of facial palsy will affect sensation including pain, as well as facial movement. This may mean that the nerve which is responsible for sensation (trigeminal nerve) has been damaged as well as the facial nerve. The facial nerve controls movement, tear production, saliva production and taste.
Loss of sensation may mean you cannot feel your face when you touch it.
Inability to blink or close the eye is a common symptom.
Loss of forehead wrinkles & inability to frown.
Droopy eyebrow and inability to raise eyebrow
Inability to close the eye fully or blink
Watery eye or dry eye
Inability to squint
Drooping of the lower eyelid which may make the eye appear wide
Painful eye with symptoms of grittiness or irritation
Sensitivity to light
Soreness or redness of the white of the eye
The corner of the mouth pulls down/droops
Inability to smile on affected side
Inability to puff up your cheeks, whistle or blow
Tingling of the affected half of the tongue
Difficulty eating and drinking
Difficulty brushing your teeth and spitting out
Drooling from the weak corner of your mouth
Excess or reduced salivation (dry mouth)
Inability to pout
Difficulty speaking because of weakness in the lips and cheek
Pain in or near the affected ear
Loss of hearing
Increased sensitivity to high pitched noise
Nose runs or feels stuffy
Inability to flare nostril
Inability to wrinkle nose
If a person develops symptoms of facial palsy slowly (over weeks or months) then they should immediately be referred for further investigations.
Main Treatment is physiotherapy & Symptomatic Treatment.
Infrared For Muscle Spasm.
Hot water fermentation.
Ptotect eyes with goggles.
Use Cotton In Ear.
Face wash regularly.