Facial nerve paralysis can occur due to lesions along the facial nerve pathway and has multiple causes. Bell's palsy, the most common type, may be caused by herpes simplex virus infection and results in sudden weakness or paralysis on one side of the face. Patients with Bell's palsy usually recover fully but some have partial or no recovery. Treatment involves antiviral medication, corticosteroids, and physical therapy exercises.

1. By:
Sakar S.Hassan

2. Facial nerve paralysis is a common problem that
involves the paralysis of any structures innervated
by the facial nerve. The pathway of the facial
nerve is long and relatively convoluted, and so
there are a number of causes that may result in
facial nerve paralysis.

3.  Supranuclear and nuclear lesions
 Infranuclear lesions:
a. Bell’s palsy
b. Moebius syndrome
c. Acute and chronic otitis media
 Multiple
a. Trauma
b. Tumors

5. Clinical features
• Facial asymmetry
• Eyebrow droop
• Loss of forehead &
nasolabial folds
• Drooping of corner of mouth
• Uncontrolled tearing
• Inability to close eye
• Lips not held tightly together: Difficulty keeping
food in mouth
• Facial muscle atrophy (Late)

6. An idiopathic sudden onset of
facial paralys,is the most common
cause of acute facial nerve paralysis
(>80%).it has been recently linked to
herpes simplex infection.Other conditions that
may cause Bell's palsy include:
 HIV infection
 Lyme disease
 Middle ear infection
 Sarcoidosis

7. Patients who develop Bell’s palsy fall into three
groups:
1. 85% of individuals completely recover from the
Bell’s palsy.
2. 10% of individuals have partial facial weakness.
3. 5% of the patients have complete facial paralysis

8. Onset
Paralysis: Progresses to maximal deficit over 3
to 72 hours
Pain (50%): Near mastoid process
Excess tearing (33%)
Other: Hyperacusis; Dysgeusia

9. Sudden weakness or paralysis
on one side of face that
causes it to droop.
Drooling.
Eye problems, such as
excessive tearing or a dry eye.
Loss of ability to taste.
Pain in or behind ear.
Numbness in the affected side of face.
Increased sensitivity to sound.

10. Primary viral infection (herpes)

11.  Early treatment (within 3 days after the onset) is
necessary for therapy to be effective.
 Steroid: Corticosteroid such as prednisone
 Antiviral :(such as acyclovir)
 Surgery
 Physiotherapy

12.  Facial exercises.
 Eye care. A dry eye can lead to sores and serious
vision problems. To help protect the eye and
keep it moist:
 Use your finger to close and open your eyelid
often throughout the day.
 Use eye drops ("artificial tears") or ointment.
Wear an eye patch , and wear glasses.
 Mouth care. Brush and floss your teeth often
and eat soft foods.