Bells Palsy & Facial Palsy

Bells Palsy & Facial Palsy

All of the muscles in your face responsible for facial expression are under the control of the seventh (VII) cranial nerve, a large nerve originating in the brain. When this nerve is weakened or damaged, such as from surgery, trauma, infection, or an unknown cause, the corresponding side of the face will be weak or paralyzed (palsied). This results in an eye that appears larger and doesn’t close well, a droopy brow, a lower eyelid that may hang away from the eye (ectropion), and a crooked smile.

A common form of facial nerve palsy is Bell’s palsy. The condition is referred to as a Bell’s palsy when all other causes of facial nerve palsy (infections such as Lyme disease, trauma, surgery, or a stroke) have been ruled out. Bell’s palsy affects approximately 40,000 people a year in the United States. It is most commonly temporary, with symptoms lasting several weeks and most people regaining full function by 3-6 months. Patients are often treated with corticosteroids (i.e. prednisone) and sometimes antiviral medications within the first 1-2 days of diagnosis. Please visit the following link for more information on Bell’s palsy: https://www.ninds.nih.gov/health-information/disorders/bells-palsy.

Whatever the cause of the facial weakness or paralysis, an eye that does not close completely will result in drying out of the cornea, decreased vision, tearing, discomfort, and in its extreme, could result in blindness. In the acute phase of facial nerve weakness, various non-surgical measures can be taken to help protect the eye. If the facial function has not returned by several months, or there is permanent weakness and difficulty closing the eye, there are various surgical procedures that can be performed. For instance, a gold or platinum weight can be placed within the upper eyelid to help with closure and the lower eyelid can be tightened to improve comfort. If a droopy brow is blocking peripheral vision, a brow lift can be performed. Board-certified ophthalmologist, fellowship-trained oculoplastic surgeon Katherine J. Zamecki-Vedder, MD, FACS has much experience in the medical and surgical treatment of facial palsy.