Overcoming Facial Palsy: Comprehensive Care from Diagnosis Through Treatment

Facial Palsy refers to the weakness or paralysis of facial muscles, usually affecting one side of the face, caused by damage to the facial nerve due to swelling or pressure. This condition impairs facial expressions and movements, impacting one’s ability to smile, frown, or close the eye on the affected side.

The facial nerve (cranial nerve VII) is like an electrical cable on each side of your face. Damage to the left facial nerve affects the left side of your face, and damage to the right nerve affects the right side. Originating in the brain (the electrical generator), the facial nerve exits through a narrow bony channel in the skull, making it vulnerable to swelling and pressure. Once in the face, it divides into five branches (depicted in yellow) to control different muscles (light bulbs) responsible for facial expressions.

In addition to controlling facial muscles, the facial nerve is crucial for tear production, saliva secretion, and taste sensation in part of the tongue. Each side of the face has 23 muscles and one muscle encircling the mouth. These muscles work in precise coordination to create expressions, such as smiling, which involves at least nine muscles on each side.

Various conditions causing swelling or pressure on the facial nerve can lead to Facial Palsy. The most common cause is Bell’s Palsy, accounting for 80% of cases, often due to the reactivation of a dormant viral infection. It can affect individuals of any age or gender, with a higher incidence in those aged 15-45. Risk factors include pregnancy, preeclampsia, obesity, hypertension, diabetes, and upper respiratory ailments.

Other causes include:
– Ramsay Hunt Syndrome: A more aggressive form caused by the Herpes Zoster virus.
– Bacterial Infections: Such as Lyme disease or middle ear infections.
– Surgical Procedures: Damage during surgery to remove benign acoustic nerve tumours (vestibular schwannoma).
– Traumatic Injuries: Fractures or deep cuts to the brain, skull, or face.

If you or someone you know experiences sudden facial paralysis or weakness, seek medical attention immediately by visiting your GP or the A&E. Identifying the cause of Facial Palsy is crucial. While Bell’s Palsy is common, thorough examinations are necessary to rule out other causes, as Bell’s Palsy is a diagnosis of exclusion.

For instance, the rash indicative of Ramsay Hunt Syndrome (RHS) may not be immediately visible, necessitating a comprehensive ear, nose, and throat examination. Correct diagnosis is vital as the prognosis for RHS is less favourable than for Bell’s Palsy, requiring closer monitoring and follow-up. Diagnosis often involves a full medical examination and, if necessary, blood tests or imaging. For more information, visit www.facialpalsy.org.uk.

Specialist facial therapy is a crucial aspect of Facial Palsy management. Caitriona, a Specialist Facial Therapist at PMC Physiotherapy, has extensive training, including completing The Advanced Management of Facial Palsy Course in 2015 and attending the Advanced Neuromuscular Retraining Course hosted by experts Jackie Diels and Susan Rankin. She is also a member of the Facial Therapy Specialists International group.

As a Facial Therapy Specialist, Caitriona conducts comprehensive assessments of facial muscles, identifying abnormal movement patterns (synkinesis). Her training acknowledges that facial muscles are unique, requiring specialised rehabilitation approaches distinct from general muscle rehab principles.

If you have been diagnosed with Facial Palsy and wish to learn more about facial NeuroMuscular Retraining or other available therapies, please contact Caitriona at PMC Physiotherapy Dunboyne on 01 8253997 or at info@pmcphysiotherapy.ie.