Facial paralysis is the loss of movement on one or both sides of your face because of a damaged facial nerve and/or facial muscles that don’t work properly. Facial paralysis can cause one side of your face to sag or spasm, or it can affect your ability to smile and show expression. It may result in drooling or difficulty closing your eyes, eating, and speaking.
Facial paralysis can occur at any time, both in childhood and adulthood. It can happen suddenly or gradually depending on the underlying cause. Some people regain movement with no treatment; however, the recovery may not be complete. Duke’s team of facial paralysis specialists evaluate your condition to determine the type and severity and recommend a personalized treatment plan. Our goals are to restore symmetry and movement to your face and to improve your quality of life.
The Causes of Facial Paralysis
A wide range of conditions can lead to facial paralysis, and the degree to which it occurs can vary greatly in children and adults.
- Congenital facial paralysis may result from positioning or trauma during pregnancy or be present at birth. For example, Moebius syndrome is a congenital condition in which children are born with undeveloped facial nerves.
- Inflammation is responsible for Bell’s palsy, the most common type of facial paralysis. It can appear suddenly when a facial nerve becomes inflamed.
- Trauma, such as a facial fracture or a deep cut on the face, can damage facial nerves and muscles.
- A tumor or growth in the head or neck can damage facial nerves. Surgery to remove the tumor may also impact the nerves and result in facial paralysis.
- A viral infection, such as HIV, Lyme disease, or Ramsay Hunt syndrome – a shingles-related infection --- can damage facial nerves.
- Autoimmune diseases that affect the nervous system, such as Guillain-Barré, or the brain or spinal cord, such as multiple sclerosis, can cause facial paralysis.
- Synkinesis refers to a rewiring of the facial nerves that can occur after Bell’s palsy or another facial nerve injury. Muscle spasms or the wrong facial movement (for example, your neck muscles tighten when your eye closes) can result.
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What to Expect at Your First Appointment
Because facial paralysis can be caused by a wide range of conditions, the first step is diagnosing the type and severity.
You will undergo an extensive evaluation that includes a physical exam, a review of your medical history, and imaging. Your doctor will check the status of your facial nerves and muscles. Pictures and videos may be taken as part of your consultation.
You Benefit from Our Team Approach
The facial paralysis team will review your records and work together to determine the best approach for your treatment. This team approach allows us to provide you with comprehensive care and takes advantage of the skills and resources of multiple specialists working together on your behalf.
Creating Your Treatment Plan
You and your doctor will discuss the team’s recommendations for your personalized treatment plan. It may include a combination of nonsurgical and surgical approaches designed to return symmetry, balance, and function to your face. Your doctor will also provide a suggested timeline for when these procedures should be performed so that you have time to heal, regenerate facial nerves, and strengthen your facial muscles.
Duke University Hospital is proud of our team and the exceptional care they provide. They are why we are once again recognized as the best hospital in North Carolina, and nationally ranked in 11 adult and 9 pediatric specialties by U.S. News & World Report for 2021–2022.