Facial Palsy

Facial palsy refers to weakness of the face, due to temporary or permanent damage to the nerve that supplies the facial muscles – the facial nerve (CN VII).

Facial palsy can occur as a result of the following conditions:

Tumours: Acoustic neuroma or facial nerve tumour, or in parotid gland and brainstem
Stroke
Traumatic brain injury, particularly with facial or skull fractures
Viral infections, such Bell’s palsy and Ramsay Hunt syndrome
Bacterial infections such as Lyme disease or following a middle ear infection
Neurological conditions such as Neurofibromatosis 2, or Guillain-Barré syndrome
Birth trauma: for example caused by forceps or facial presentation delivery
Congenital conditions
Autoimmune disorders such as sarcoidosis
Rare genetic syndromes such as Moebius syndrome or CHARGE syndrome
Vascular masses

Common challenges:

Pain
Discomfort with moving your face
Synkinesis, or unwanted facial movements
Gross asymmetry
Difficulty eating and talking clearly
Dry or irritated eye
Overcompensation from the other side of the face

The role of the neurological physiotherapist in facial palsy:

Neurological physiotherapists are physiotherapists with additional training and expertise in treating problems related to the brain, spinal cord, inner ear and nerves. At Klint, we have a special interest in facial rehabilitation and are able to deliver quality care to this group of clients. It is particularly important to work on this area delicately as improper treatment can increase unwanted movement (synkinesis), spasms and pain.

We adopt careful techniques in teaching you neuromuscular retraining, which allows you to regain control and coordination of your face following injury or disease. Each client will undergo careful evaluation and assessment, to determine whether you would be appropriate for neuromuscular retraining at that particular point in time during your recovery.

What our skilled therapists can offer:

Our therapists can perform clinical tests to help guide you towards a diagnosis. These include:

A thorough assessment and analysis of your facial anatomy and movements
An explanation of the neurological recovery process in your particular case
Techniques to restore tissue mobility
Neuromuscular training for lip seal and closure, resulting in better speech diction
Teach you how to improve your facial expression repertoire
Teach you how to improve and reduce your unwanted involuntary movement (synkinesis)
Improve your confidence and self esteem

During the recovery process, we will adopt some neuroplasticity principles in the form of sensory and motor relearning to assist you in relearning movement and guide you accordingly with objective outcomes so you can rest assured that your progress is carefully documented and checked during each consultation.

We may also consider referring you to other health professionals to assist in your care, depending on your specific needs.

Frequently Asked Questions

What is facial palsy?

Facial palsy, is a condition that causes sudden weakness or paralysis of the facial muscles, typically on one side of the face. It results from dysfunction in the facial nerve and can affect expressions and other facial functions. Bells palsy is a form of facial palsy where there is an unknown cause of facial palsy with inflammation of the nerve, injuring the nerve short or long-term.

What causes facial palsy?

The exact cause of facial palsy is sometimes unknown, but it is commonly linked with viral or bacterial infections like herpes simplex, Lyme disease, and influenza have been linked to the onset of facial palsy. Facial palsy can also occur from cancer, trauma, plastic or reconstructive surgery, or head and neck surgery.

What are the symptoms of facial palsy?

Symptoms include sudden weakness or paralysis on one side of the face, drooping of the eyelid and corner of the mouth, difficulty smiling or closing the eye, and occasionally, pain around the jaw or behind the ear on the affected side. Saliva, taste and altered hearing can also occur. In some instances there is sharp or dull pain around the ear or face.

How is facial palsy diagnosed?

Diagnosis typically involves a physical examination to assess the extent of facial weakness. Imaging tests like MRI or CT scans may be used to rule out other causes, and sometimes electrical testing is conducted to determine nerve function.

What treatment options are available for facial palsy?

Treatment often involves corticosteroids to reduce inflammation, antiviral medications if a virus is suspected, and protecting the eye from drying out with lubricating drops or ointment. Physical therapy can also be beneficial in restoring facial muscle control.

Can facial palsy be prevented?

Preventing facial palsy focuses on managing and preventing the infections that may cause it. Maintaining general health and promptly treating viral infections can reduce the risk.

Is facial palsy permanent?

In many cases, facial palsy is temporary, and significant improvement is often seen within a few weeks to months. However, some individuals may experience lasting effects or incomplete recovery.

How long does recovery from facial palsy take?

Recovery varies widely; most patients start to see improvement within two to three weeks, and complete recovery can take three to six months. Some may have longer recovery times, depending on the severity of the nerve damage.

What complications can arise from facial palsy?

Complications may include incomplete facial movement restoration, synkinesis (involuntary facial movements), and changes in taste. Persistent dry eye or corneal scratches can occur if the eyelid does not close properly.

Are there support resources for people with facial palsy?

Yes, numerous support groups and resources are available for individuals with facial palsy. These provide education, therapy options, and emotional support to help manage the condition and improve quality of life.