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Facial paralysis
Facial paralysis is the inability of one or both sides of the face’s muscles to move. Facial paralysis can be caused by disease, trauma, or congenital (existing at birth) conditions that cause nerve injuries like Bell’s palsy, stroke or brain tumours.
Due to facial paralysis, facial muscles could seem to sag or weaken. Facial paralysis can be experienced on either side of the face resulting in difficulty speaking, blinking, swallowing saliva, eating or expressing oneself naturally with facial expressions. In addition to that, facial paralysis is also called facial palsy.
Symptoms of facial paralysis
The following are some of the early symptoms of facial paralysis.
Difficulty speaking, eating or drinking
Patients with facial paralysis experience difficulty eating and drinking.
Facial palsy can weaken the lips, making it challenging to eat and drink. You might be hesitant to eat with others because eating and drinking can be messy due to this condition.
The lips may become brittle, and the cheek muscles may lose or become less toned if the facial nerve is injured. Your speech may get muddled, and as a result, you could notice that it sounds different or is more difficult to pronounce.
Drooling
Due to an inability to control facial muscles, drooling becomes a common problem. Constant drooling can result in a sore mouth, thus making it difficult to eat.
Dry eyes
Facial nerve paralysis frequently produces dry eyes and makes it harder to close the eye.
Most of the time, symptoms go away quickly, but they might also last a lifetime. Hemifacial paralysis, which results in facial deformities, is the primary symptom. Drooping eyelids and poor blinking cause dry eyes.
Ear pain
A slight temperature increase, pain in the ear and weakness on one side of the face may be the first signs of facial paralysis. These symptoms can be unexpected and quick.
Loss of taste
Facial palsy can occasionally accompany other symptoms like taste loss, tinnitus, hearing loss and dizziness.
Oral and perioral infections, oral appliances, head trauma and mass lesions of the taste pathways are among the common causes of taste loss.
Causes of facial paralysis
The following are the essential causes of facial paralysis.
Stroke
Facial paralysis occurs due to the brain nerves that manage the muscles in the face being affected by stroke.
Depending on the type of stroke, the brain cells are either damaged by a lack of oxygen or by an excess of pressure brought on by bleeding.
Bell’s palsy
Bell’s palsy is a disorder that causes any one side of the facial muscles to cause weakness. The weakness is only temporary and usually goes away over the course of a few weeks. The weakening makes the lower portion of the face look sagging.
Lyme disease
Lyme disease causes facial tone problems and impairs face muscles’ mobility. It may also cause permanent facial muscle tightness and involuntary facial movements.
Neurosarcoidosis
A tiny percentage of patients have some type of nervous system problem due to neurosarcoidosis. This condition is deeply associated with facial palsy, a common neurological ailment that affects the muscles of the face.
Brain tumour
Facial paralysis is seen high in people who are diagnosed with brain tumour.
Tumours can impact the facial nerve in a variety of ways. The facial nerve in the brainstem is located extremely close to the posterior fossa of the skull, where brain cancers like medulloblastomas can develop.
Treatment for facial paralysis
The following are the treatments given for facial paralysis.
Facial paralysis surgery
Facial reanimation surgery is another name for facial paralysis surgery. To restore motion to the lower half of the face, facial plastic surgery is used by surgeons.
This surgery is also known as “smile surgery,” which can recover your capacity to grin naturally after a facial nerve injury has paralysed your face.
Nerve Transfers
Masseteric nerve transfer is one of the most used nerve transfer techniques for facial paralysis. A patient’s smile is restored during this treatment by redirecting the masseteric nerve to the injured facial nerve.
Patients with total facial paralysis benefit tremendously from masseter nerve transfer. This is also known as trigeminal nerve transfers. This therapy has proven quite effective at the Facial Paralysis Institute in treating patients who have had paralysis for less than three years.
Temporalis Tendon Transfer
A temporalis tendon transfer is a comparatively minimally invasive procedure for the dynamic reanimation of the paralysed face. Surgeons widely prefer this treatment method as it is more effective and reliable for treatment.
Gracilis muscle transplant
When facial paralysis has lasted more than two years, the Gracilis free muscle transfer is employed. In such circumstances, the facial muscles cannot receive new nerve signals. A new muscle must be implanted to restore the grin and tone of the face.
A little piece of a patient’s inner thigh muscle is transplanted into the face during a highly specialised treatment known as a “Gracilis muscle transplant”.
Cross-Facial Nerve Graft
In order to stimulate the paralysed side of the face with nerve stimulation, the cross-face nerve graft procedure is utilised in facial paralysis surgery.
The cross-face graft directs the nerve fibres that are rebuilding to replenish the wounded facial expressive muscles.
First surgery
The surgeon cuts the sural nerve from the lower leg, attaches it to a facial nerve branch on the patient’s regular side and tunnels the other end of the nerve under the skin to place it in the paralysed area of the patient’s face. The little toe and the outside of the foot may feel a bit numb after the nerve is removed.
Second surgery
Following the gracilis muscle transfer, the surgeon joins the cross-facial nerve graft to the nerve that controls it. This surgery is known as “Second surgery”.
Dual Innervation
Dual innervation has been used in free muscle flap facial reanimation to produce a robust commissure excursion with the masseter nerve and aids in the recovery of facial paralysis.
Medication for facial nerve paralysis
The following are the medications given for facial nerve paralysis.
Corticosteroids
Corticosteroids are effective in reducing the symptoms developed due to facial paralysis.
Antiviral Medications
Apart from corticosteroids alone, the combination of antivirals and corticosteroids likely reduces facial palsy conditions. Studies also showed that subjects treated with corticosteroids experienced fewer occurrences of long-term sequelae than persons treated with antivirals.
Eye Drops
Patients with facial paralysis should use 1-2 drops in their eyes due to their inability to close their eyes while they sleep. Bell’s palsy and facial palsy patients face the most significant obstacle in treating dry eye at night.
Conclusion
When something interferes with the nerve signals travelling from the brain to the muscles in the face, facial paralysis results.
A number of illnesses, such as Bell’s palsy, stroke, Lyme disease, neurosarcoidosis and a brain tumour, can cause facial paralysis as a symptom.
People affected by facial paralysis should consult a physician. It also applies to people who are exhibiting stroke symptoms.
Unfortunately, some instances of facial paralysis may never fully recover, even though numerous treatment options are available. Physical therapy and eye care can assist these folks in avoiding future harm and enhance their quality of life.
FAQ
Which doctor should be consulted in Facial Paralysis?
A health care physician, an ENT (ear, nose and throat) specialist, or an otolaryngologist may be consulted in facial paralysis
Will my children be affected by facial paralysis?
It is very uncommon for children to have congenital (existing at birth) or acquired facial paralysis.
Will Facial Paralysis happen again?
Bell’s palsy can strike more than once in a person’s lifetime. Most certainly, two years after the initial incident, there will be another one. Your face may be affected by facial nerve palsy on the same. You are more likely to face recurrence if the disease runs in your family.
Does Facial Paralysis affect any other parts of the body?
No, facial paralysis only affects the face and does not harm any body parts.
Can an injured facial nerve be repaired?
In many instances, facial nerve injury is repairable. But, the degree and duration of the nerve damage determine the success rate.
What should I do if my facial paralysis hasn’t fully healed?
In most of the time, facial palsy or facial paralysis is transient. Most people regain full motion and function of their face within three months.
How does Botox help with facial paralysis?
Botox impedes the release of acetylcholine, a neurotransmitter that neurons use to instruct muscles to contract or tighten. Additionally, Synkinesis or the involuntary movement of the face, can be prevented by Botox, which relaxes overly tight muscles.
My child was born with facial paralysis. How early can it be treated?
Children are rarely diagnosed with facial paralysis condition. Most children’s facial paralysis condition occurs to children who are diagnosed with bell’s palsy.
Does bell’s palsy cause all facial paralysis?
No, Bell’s palsy is said to be one of the reasons for the cause of facial paralysis.
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