Facial paralysis can be caused by various conditions, including Bell’s palsy, viral infections, fractures, tumors, strokes, and congenital conditions. Treatment options vary depending on the cause and severity of the paralysis.
Facial paralysis, or the inability to control your facial muscles, can result from a number of conditions. The most common cause is Bell’s palsy. Other possible causes include viral infections, fractures, tumors or strokes. Children can be born with congenital facial paralysis or it can be acquired.
Bell’s palsy causes one-sided or one-sided facial paralysis. It may be caused by a viral infection, possibly herpes simplex 1, which causes swelling of the facial nerve. The paralysis generally goes away in about two weeks, although it takes some people up to three months to fully heal. A small number of Bell’s palsy sufferers have permanent symptoms.
Viral infections are known to cause facial paralysis. If the facial nerve near the ear becomes infected with the shingles virus, Ramsay-Hunt syndrome can occur. Symptoms of Ramsay Hunt syndrome include shingles rash, hearing loss, dizziness, and facial paralysis. Treatment with antiviral drugs and corticosteroids helps avoid permanent damage.
Otitis media, or a middle ear infection, can also cause facial paralysis if the infection spreads to the facial nerve. An infected nerve can become inflamed, swollen, and compressed in the ear canal. The first line of treatment is antibiotics. If that doesn’t help, a myringotomy or tympanic membrane incision may be needed.
Temporal bone fractures can also be responsible for facial paralysis. A horizontal transverse fracture causes paralysis in 40-50% of cases. Symptoms can include dizziness, blood behind the tympanic membrane, and hearing loss. A vertical longitudinal fracture of the temporal bone causes paralysis in 20% of cases. The patient with this type of fracture may experience symptoms such as blood leaking from the ear canal, laceration of the tympanic membrane, hearing loss or fracture of the ear canal. Treatment may include surgery or benzodiazapines.
A tumor can cause paralysis that gets worse over time and can shrink. Sometimes it is quite difficult for the surgeon to remove the tumor without damaging the nerve. If the tumor is benign, care may be taken to preserve as much of the nerve as possible. Malignant tumors may require resection of part of the facial nerve and some surrounding nonmalignant tissue; this will likely result in more severe facial paralysis.
A stroke that damages the upper motor neurons of the facial nerve can lead to central facial paralysis. It usually causes paralysis of the lower half of one side of the face. Physical or occupational therapy may be recommended to help strengthen muscles.
Babies can sometimes be born with facial paralysis. It could even be later in childhood. Paralysis can affect one or both sides. Unilateral paralysis could be caused by Goldenhar syndrome. This is a type of hemifacial microsomia in which one side of the face has developed more fully than the other.
Moebius syndrome is a congenital condition that causes bilateral facial paralysis. This condition can be caused by incomplete development of the blood vessels that feed the muscles and nerves in the face. Children with this condition cannot show emotion or move their eyes from side to side.
Acquired facial paralysis can occur in babies born with forceps. This nerve injury usually clears up over several months, but sometimes the paralysis is permanent. Surgical treatment may be suggested to correct the paralysis. Head injuries, muscle damage, or severed facial nerve are other reasons a child may develop acquired paralysis of the face.
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