The facial nerve supplies the muscles of the facial expressions. Causes of the facial nerve palsy can include viral or bacterial infections, brain tumors, strokes, injuries and surgeries.
Most commonly no specific cause is found and the condition is then described as Bell’s palsy.
Facial nerve palsy can cause drooping of the face, twitching, difficulty making facial expressions, drooling and occasionally loss of taste. With regards to the periocular area, it causes inability closing the eye, therefore increasing the risk of exposure of the ophthalmic surface leading to potential infections and corneal ulcers.
The diagnosis is clinical but requires neuroimaging too with CT and head MRI.
Treatment varies depending on cause and severity of the condition. Conservative measures include observation alone, oral steroid and/or antiviral treatment, intensive ocular lubrication and moisturizing eye chambers at night.
Surgery is offered either to restore cosmesis and/or to prevent eye damage from the exposure of the ocular surface. Several surgical procedures can be offered on an individual basis varying from eyelid tightening, eyebrow lift, upper lid lowering and mid face lift.