Facial paralysis can occur for many different reasons. The most common forms of facial paralysis include:
Bells Palsy (idiopathic facial paralysis)
This is the most common form of acute paralysis of the seventh (facial) cranial nerve affecting 23 of 100,000 people at any time. The exact cause of Bells palsy is not known. Swelling and compression of the facial nerve may be contributing factors to this condition. Recent research suggests that Bells palsy may be the result of a Herpes simplex virus (HSV) outbreak. HSV is the same virus that can express itself as cold sores on the lips. Treatment with corticosteroids (prednisone) and antiviral therapy (e.g. acyclovir, valtrex) during the first 72 hours may improve the speed and quality of facial recovery. Up to 80% of people experience spontaneous recovery that is close to complete or complete. Some people suffer from complete paralysis of one side of the face including the inability to blink while others suffer from partial paralysis. Complete recovery from partial paralysis is likely within a few months. Recovery varies more for those with complete paralysis so an aggressive treatment approach is important.
Pregnancy Related Facial Paralysis (Bells palsy during pregnancy or immediately post childbirth)
Bells palsy occurrences during third trimester pregnancy are not uncommon. This may be due to swelling that can cause compression on the facial nerve as it exits the skull or elsewhere. This also may be due to the fact that when demands on the body are extreme (as in the third trimester of pregnancy) the mother's immune system may be compromised and less able to tolerate swelling, stress and/or viral exposure.
Ramsay Hunt Syndrome
Acoustic Neuroma (also called Vestibular Schwannoma or neurolemmoma)
An acoustic neuroma is a non-cancerous tumor that slowly grows on the eighth (vestibulocochlear) cranial nerve. This overproduction of Schwann cells can grow to press against the hearing and balance nerves and cause hearing loss, ringing, dizziness and balance problems. Acoustic neuromas may also press on the nerves controlling face sensation (trigeminal nerve) and face movement (facial nerve) resulting in facial numbness, weakness, or paralysis.
Treatment options include monitoring the neuroma, radiation, and surgery. Typically, acoustic neuromas are surgically removed to avoid further growth and increased pressure on vital brain structures. Acoustic neuromas can grow on to the facial nerve and surgical removal of the tumor may require removal of a segment of the facial nerve. Even if the facial nerve was not removed or touched during removal of an acoustic neuroma, inflammation in the area can cause facial nerve dysfunction including temporary or permanent facial paralysis.
Neurofibromatosis Type 2 (NF-2)
Neurofibromatosis Type 2 (NF-2) is an inherited disorder where noncancerous tumors grow on various nerves throughout the body. This can include tumors in the head and on the hearing nerve. These tumors can grow to press against the hearing, balance and facial nerves causing hearing loss, ringing, dizziness, balance problems, facial numbness, facial weakness, or facial paralysis.
Traumatic Injury Induced Facial Paralysis
The facial nerve travels a complex course from the brainstem through the temporal bone and out of the bottom of the skull to the muscles of the face. A fractured temporal bone or infection in the middle ear can affect any of the many branches off the facial nerve throughout its course. Traumas such as a blow to the head, automobile accident, fall, concussion and even forceps delivery can cause facial nerve symptoms including but not limited to facial muscle weakness or paralysis.
Other Possible Causes of Facial Paralysis
Other possible causes of facial paralysis include Lyme disease, mastoiditis, encephalitis, Gullian-Barre Syndrome, Mobius syndrome and Diabetes mellitus.
*Treatment for facial paralysis as a result of Lyme disease.
*Treatment for facial paralysis as a result of mastoiditis.
*Treatment for facial paralysis as a result of encephalitis.
*Treatment for facial paralysis as a result of Gullian-Barre syndrome.
*Treatment for facial paralysis as a result of Mobius syndrome.
*Treatment for facial paralysis as a result of Diabetes mellitus.
