Bell's palsy is the most common cause of facial palsy, which occurs due to dysfunction of the facial nerve, leading to weakness or loss of facial movement. The abnormal facial movement can impact patients' everyday activities, including eating, speaking, smiling, and blinking or closing the eyes. Therefore, facial palsy can have profound social, emotional, and functional consequences for patients.
Even though Bell's palsy is the most common cause of facial palsy, it should only be diagnosed after other potential causes have been ruled out. Other potential causes of facial palsy include stroke, Lyme disease, Ramsay Hunt syndrome, brain tumor, head and neck tumor, trauma, surgery, and congenital abnormalities.
What are the symptoms of facial palsy?
Symptoms of facial palsy include:
- Facial asymmetry
- Facial muscle weakness
- Difficulty closing eyes
- Abnormal blinking
- Difficulty making facial expressions
- Changes in saliva and tear production
- Changes in taste on the affected side of mouth
- Sound sensitivity
How is facial palsy treated?
Patients with facial palsy should receive integrated care from a team of experts which usually includes facial plastic surgeons, oculofacial plastic surgeons, ophthalmologists, occupational therapists, but may also include optometrists, neurologists, otologists, and skull base surgeons.
Some patients with chronic facial palsy may be treated with procedures to restore facial movements and symmetry. These procedures may include free tissue transfer, nerve transfer, muscle transfer, and nerve grafting. Static surgical procedures are also available to improve symmetry and function of the eyelid, brow, lip, and face.
How can I protect my eyes if I have facial palsy?
Facial palsy can weaken eyelid closure and blink. This often results in corneal dryness, but can also cause corneal scratches, or, in severe cases, even vision loss.
Every patient with facial palsy involving their eyelids should seek care from an ophthalmologist to receive a baseline eye exam. This helps determine the impact of facial palsy on the health of the eye. An oculofacial plastic surgeon is also often involved to assess the impact of facial palsy on the eyelids and develop an individualized treatment plan for patients to improve the function and position of the eyelids.
While waiting for a clinic visit, patients should use preservative-free artificial tears at least 4-6 times a day, and preservative-free artificial tear ointment while sleeping.
In this review article and this study, co-authored by Dr. Shannon S. Joseph, you can find a comprehensive summary of the impact of facial palsy on the health of the eye, and the management options available for patients with facial palsy affecting the eye.
Schedule a consultation
If you are have been diagnosed with Bell's palsy or facial palsy, please contact us to schedule a personal consultation with Dr. Shannon S. Joseph. She founded and was co-director of the Michigan Medicine Multidisciplinary Facial Nerve Clinic while on faculty at the University of Michigan and has extensive experience taking care of patients with facial palsy. She will perform a comprehensive evaluation and work with you to develop an individualized management plan that is tailored to you.
