Health Encyclopedia

Facial nerve palsy

Definition

Facial nerve palsy is a nervous system disorder in which a damaged nerve in the skull affects the movement of the muscles of the face.

It is a form of cranial mononeuropathy VII.

Alternative Names

Neuropathy - facial; Cranial mononeuropathy VII; Seventh cranial nerve palsy

Causes, incidence, and risk factors

Facial nerve palsy occurs when there is damage to the seventh cranial (facial) nerve. It is a type of mononeuropathy. The seventh facial nerve is located in the skull. It controls movement of the muscles of the face. It also affects feeling in the ear canal and the sense of taste.

This type of nerve damage may occur with local growths, such as a tumor, that put pressure on the facial nerve.

Facial nerve palsy may also be caused by:

It also may have no obvious cause.

Symptoms

Change in the appearance of the face
- Difficulty closing one eye
- Difficulty making expressions, grimacing
- Difficulty with fine movements of the face
- Facial droop
- Paralysis of one side of the face
Difficulty eating (items fall out of the weak corner of the mouth)
Face feels pulled to one side
Face feels stiff
Headache
Impairment of taste
Increased loudness of sound in one ear
Pain behind the ear (for Bell's palsy)
Sensitivity to sound (hyperacusis)

Signs and tests

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).

A blood test may be done to check for Lyme disease. Other tests may include:

Lumbar puncture
MRI of the head
Tests to rule out a stroke or other nervous system problems

Treatment

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.

Your doctor may recommend lubricating eye drops or eye ointments to protect the eye if it doesn't close completely. You may need to wear a patch over the eye while you sleep.

Your health care provider may recommend surgery to remove any tumors that are pressing on the facial nerve.

Expectations (prognosis)

The outlook varies. Some patients recover completely, while others permanently lose movement of the face.

Complications

Changes to the appearance of the face (disfigurement) from loss of movement
Changes to taste
Damage to the eye (corneal ulcers and infections)
Nerves that grow back to the wrong structures (aberrant regeneration) -- for example, smiling causes the eye to close
Spasm of face muscles or eyelids

Calling your health care provider

Call your health care provider if your face droops or you have other symptoms of facial nerve palsy.

Prevention

Quickly treating tumors or other growths that press down on the facial nerve may reduce the risk of facial nerve palsy in some cases.

Review Date:2/6/2008
Reviewed By:Daniel Kantor, MD, Director of the Comprehensive MS Center, Neuroscience Institute, University of Florida Health Science Center, Jacksonville, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

ADAM Quality A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial process. A.D.A.M. is also a founding member of Hi-Ethics (www.hiethics.com) and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The Agency for Health Care Administration (Agency) and this website do not claim the information on, or referred to by, this site is error free. This site may include links to websites of other government agencies or private groups. Our Agency and this website do not control such sites and are not responsible for their content. Reference to or links to any other group, product, service, or information does not mean our Agency or this website approves of that group, product, service, or information.

Additionally, while health information provided through this website may be a valuable resource for the public, it is not designed to offer medical advice. Talk with your doctor about medical care questions you may have.