Bell’s Palsy

(Facial nerve palsy)

The facial nerve controls the muscles of facial expression. It allows a person to raise the brows, frown, close the eyes tightly, smile, puff the cheeks out or move the mouth. Part of the facial nerve is also responsible for controlling taste. The facial nerve is also known as the 7th cranial nerve, and comes from deep within the brain.

When the facial nerve is not working properly, the facial muscles will be weak. The lower face will look droopy. Occasionally, the forehead and brow will look droopy as well. The affected eye will be more open, and it will be difficult to close the eyelid. 

When a cause is not identified for a facial palsy, it is called Bell’s palsy. Some other causes of facial palsy include infections (such as Lyme or a herpes virus), inflammation from autoimmune conditions, stroke, compression from a tumor, or direct injury from trauma. A detailed MRI of the brain with contrast may be able to detect the cause. In most cases, when a cause cannot be found, a herpes virus is presumed to be responsible.

Facial palsy occurs mainly in adults, though it may affect children as well.

Treatment of a Bell’s palsy may involve a short course of oral medications (an antiviral and corticosteroid). If a specific cause of the facial palsy is identified, treatment will be aimed at the specific cause. Dr. Banik will discuss all possible treatment options with you.

If there is difficulty closing the eyelid, the eye is at risk for becoming very dry. Severe dry eye may result in corneal damage, or even a corneal ulcer. Dry eye from a facial palsy requires aggressive treatment with lubricating drops or ointment to help prevent long-term corneal damage.

Bell’s palsy tends to have a very good outcome, with most patients experiencing full, or nearly full, recovery of facial function. However, recovery may take months, or sometimes a year or more. Patience is key.

Occasionally, recovery of a facial palsy can be associated with spasm of one side of the face, or hemifacial spasm. Dr. Banik has over 20 years’ experience treating hemifacial spasm successfully using onabotulinum toxin A (Botox) injections.

Whether Rudrani Banik, MD is the first Neuro-Ophthalmologist you are visiting for treatment of facial palsy, or the last one, she will make sure she does everything in her power to find an effective treatment to help you see and function better.