Treating and managing Facial Paralysis

Facial ParalysisFacial paralysis happens when there is a loss of facial movement usually as a result of nerve damage. The facial nerve stretches down each side of the face and allows a person to laugh, smile, frown, lift the eye brows and close the eyelids. When the nerve is functioning properly, the person doesn’t even think about performing the movements; they just accompany various brain functions. But when there is damage to the facial nerve or to the area of the brain that sends signals to the muscles of the face, facial paralysis results.

Dr. Shams is experienced diagnosing and treating facial paralysis and nerve palsy.

What are the symptoms of facial paralysis?

The symptoms of facial paralysis can vary depending on the cause, but these are some typical symptoms:

  • Difficulty making facial expressions
  • Twitching
  • Drooping of the face, usually on one side
  • Drooling
  • A watery or painful eye
  • Loss of taste
  • Inability to close the eyelids

What causes facial paralysis?

Bell’s palsy is the most common cause of facial paralysis. Every year, around 1 in 5000 people experience sudden facial paralysis due to Bell’s palsy. This condition causes the muscles on one side of the face to droop. It’s common for the patient to believe he or she has suffered a stroke, but this is not the case with Bell’s palsy. Its cause is actually a mystery, but there is some thought it is related to a viral infection of the facial nerve. Unlike stroke sufferers, whose effects can be permanent or require lengthy therapy to overcome, most Bell’s palsy sufferers make a full recovery in around six months.

Stroke is more serious. The facial paralysis that accompanies a stroke happens when nerves that control the muscles in the face are damaged in the brain. This damage can be caused by lack of oxygen, or excess pressure on the brain cells caused by bleeding. It can also be caused following surgery for a brain tumour or parotid gland tumour.

Other causes of facial paralysis:

  • Skull fracture or facial injury
  • Head or neck tumor
  • Middle ear infection or ear damage
  • Lyme disease due to tick bite
  • Autoimmune diseases

Diagnosis and treatment of facial paralysis

Dr. Shams will utilize a physical examination and blood tests for initial diagnosis of a patient’s facial paralysis. She may also use an MRI, CT scan, or electromyography.

As for treatment, that will depend on the cause. In cases of Bell’s palsy, it usually will resolve itself. Otherwise, treatment options may include medication, physical therapy, or surgery to improve eye closure, asymmetry in the eyelids or eye brows, watery eye and eye discomfort. She pays special attention to the protection of the eye in cases where the facial nerve is paralysed. If the eyelid cannot close, the use of eyedrops, eye ointments, external or internal eyelid weights and eyelid tightening procedures are possible treatment options.

Occasionally facial nerve palsy is following by development of abnormal facial movements or twitching, known as aberrant regeneration or facial synkinesis. Dr Shams can treat these abnormal spasms with injections of Botulinum Toxin.

If you have acute or chronic facial paralysis and would like to discuss treatment options call Dr Shams 07488 909 008 to arrange a consultation.


Posted in: Facial Nerve Palsy

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My NHS practice is based at the world-renowned Moorfields Eye Hospital in London. I consult private patients at Moorfields Private Eye Hospital, Weymouth Street Hospital, Phoenix Hospital Group Outpatient Centre and The Harley Street Clinic.

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