Facial nerve syndrome

The facial nerve (facialis) controls the facial muscles. It helps us make different facial expressions, as well as laugh and cry. It’s the seventh cranial nerve out of 12. It also plays a role in tasting food.

Pathologies of the facial nerve may cause paralysis to the facial muscles, weakness or an involuntary shortening of some facial muscles. Following a viral infection, most often after a cold, the nerve swells in the narrow space in the of the bone canal which it passes through and stops sending nerve signals to the facial muscles due to the compression caused. Because of this, they become paralysed and stop working properly. An asymmetry develops between the healthy and affected parts. The paralysed part is sluggish and slack, making it impossible for the eye to close. The corner of the mouth is dragged over to the healthy side. Taste receptors also often compromised.

Causes of facial nerve paralysis may include:

  • Cold/chill
  • Trauma to the skull region
  • Damage to the nervous system, including stroke
  • Middle ear infection
  • Herpes zoster (shingles)
  • Tumour

Most common symptoms in facial nerve paralysis are:

  • Muscle weakness and slackening of the whole side of the face where the lesion has occurred
  • Inability to wrinkle forehead and raise eyebrow on the affected side of the face
  • Inability to blow up one’s cheeks and show teeth.
  • Inability to whistle
  • Reduced taste sensation at the front 2/3 of the tongue
  • Increased or reduced tear secretion (on the affected side)
  • Pain in the area behind the ear

In most cases, diagnosis is made on the basis of the exact symptoms, provided the medic is well-trained to spot them. Further tests are needed, however, to identify the cause.

EMG test results are vital in determining the prognosis – electromyography shows the electrical activity of the nerve fibres both while active and at rest and assesses speed at which nerve signals are sent.

If facial nerve paralysis is suspected, it is important to see a neurologist who will do the right tests and identify the cause of the nerve damage. Early medical treatment is also vital. Pregnant women should not follow treatment, however, as they cannot take most of the medication.

Rehabilitation aims to restore the affected tissues. At Okta’s physiotherapy bio centre we have the right equipment to improve the nerve’s conductivity and stimulate the correct muscles.

The rehabilitation programme includes massage and exercise which must also be done at home. Recovery times vary depending on the exact. nature of the nerve damage.