What is facial palsy?

Facial palsy describes the inability to move facial muscles normally. It may affect one side or both sides of the face. Facial palsy occurs when there is loss of function to the facial nerve.

Also known as cranial nerve VII, the facial nerve exits the base of the skull near each ear and then branches out into five main smaller nerves. These smaller branches connect to different muscles in the face to activate various functions, such as smiling, speaking, and blinking.

Sometimes the cause of facial nerve dysfunction is unknown, a condition called Bell’s palsy. Known causes include disease and injury.

illustration showing the symptoms of facial palsy
The symptoms of facial palsy.

Facial Palsy Symptoms

The main symptom of facial palsy is weakness or paralysis on one side or both sides of the face. Some people may also experience pain or abnormal sensations in the face. Depending on the nerve branches affected, specific symptoms may include:

  • Changes in taste
  • Eye dryness or excessive tearing
  • Difficulty blinking
  • Difficulty eating, drinking, or speaking 
  • Difficulty making facial expressions
  • Drooling
  • Drooping of the mouth
  • Intolerance to loud noise

Facial Palsy Treatments

Treatment for facial palsy depends on its cause as well as the extent of the paralysis/weakness and how long it has been present.

Bell’s palsy can often be treated with oral corticosteroids, which reduce inflammation of the facial nerve. They are generally most effective when started within 72 hours of symptom onset.

Some people with facial palsy may be candidates for facial reanimation, in which a surgeon repairs the nerve or uses healthy tissue to substitute its function and restore movement to the face.

Some patients may also see improvement by performing specific exercises for the facial muscles under the guidance of a physical therapist. Individuals who have difficulty speaking due to facial palsy may benefit from speech therapy.

Additional Information

Who gets facial palsy?

Facial palsy can affect anyone, with many cases having no identifiable cause. 

Known causes include:

  • Brain tumors, particularly acoustic neuromas due to their proximity to the facial nerve
  • Congenital condition (a condition present at birth), such as Moebius syndrome
  • Lyme disease
  • Myasthenia gravis
  • Stroke
  • Trauma

Risk factors include:

  • Diabetes
  • Hypertension
  • Obesity
  • Preeclampsia
  • Pregnancy
  • Respiratory illnesses

How common is facial palsy?

Bell’s palsy, the most common type of facial palsy, affects about 40,000 people in the United States every year.

How is facial palsy diagnosed?

Your doctor can diagnose facial palsy by performing a physical examination and reviewing your medical history. To determine the extent of the nerve damage, any related conditions, and the best course of treatment, your doctor may order the following tests:

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Bell’s palsy affects about 40,000 people in the U.S. every year
Medically Reviewed by Randall W. Porter, MD and Christine Oh, MD on January 6, 2022