About Facial Nerve Paralysis
UW Health's Facial Nerve Clinic at UW Hospital and Clinics in Madison, Wisconsin, provides a multidisciplinary approach to diagnosing and treating facial paralysis in children and adults. Our clinic includes a multidisciplinary team involving otologists, otolaryngologists (ear, nose and throat surgeons), facial plastic surgeons, oculoplastics and facial nerve therapy experts, working side-by-side to offer an individualized treatment plan to suit your specific needs.
Types of Facial Nerve Disorders
Facial nerve disorders are characterized by drooping of one side of the face and can be classified into one of two types:
- Paresis: Patients with incomplete loss of facial movement, who have some ability to move the muscles in the face
- Paralysis: Patients with complete paralysis have absolutely no ability to move the muscles in the face
About Facial Nerve Disorders
The facial nerve is responsible for many functions in the head and neck including movement of facial muscles, stimulating secretions of tears and saliva and transmission of sensory information. The following symptoms are symptoms associated with facial nerve disorders:
- Paresis (weakness) or paralysis on one side of the face, such as difficulty with facial expression like smiling or difficulty closing the eye
- Decrease in saliva production or a change in tear production
- Change in sense of taste on one side of the mouth
- Sensitivity to loud sounds
- Pain around the ear on the affected side
Additionally, patients with facial palsies may experience depression or low self-esteem related to this change in appearance.
When Should I See a Specialist?
If you are experiencing facial nerve weakness and have not been evaluated, you should immediately contact your primary care provider. If you cannot be seen by your provider, go to the nearest emergency room so that the emergency doctor can rule out other serious causes and discuss medications with you.
- Your doctor may refer you to a specialist if they suspect an underlying cause of facial paralysis.
- After your initial evaluation, a specialist should evaluate you if any new neurologic symptoms occur, or if your facial weakness worsens. You should contact your primary care provider if this occurs.
- Eye care is extremely important, and you should sure to discuss this with your doctor, who may recommend an evaluation by an eye specialist.
- If facial weakness persists three months after your initial symptoms, the team at the Facial Nerve Clinic should evaluate you.
Examples of Facial Paralysis
Flaccid Facial Paralysis
Facial paralysis causes weakness to many muscles of the face. In flaccid paralysis, all muscle tone is lost and no movement exists, resulting in eyebrow and lower eyelid droop, inability to close eye, midface sagging, nasal twisting and obstruction, lower face droop with sagging at the corner of the mouth, difficulty eating, and inability to smile.
Synkesis After Facial Paralysis
Although many patients with flaccid facial paralysis will see improvement, sometimes the facial muscles can "over-correct" causing the face to become tight, stiff or "heavy". The eye may appear small. The crease between the side of the nose and corner of mouth (nasolabial fold) may seem deeper than the unaffected side. In some cases, the facial nerve can heal improperly causing muscles to contract out of sequence at the same time. For example, the eye may close during a smile or pucker, or the cheek may pull up when the eye closes. This improper movement, called synkinesis, can result in uncoordinated or distorted facial expression.