Facial Hemiplegia and treatments for it
Facial hemiplegia simply means paralysis of one side of the face. In medical terminology, facial hemiplegia is better known as facial nerve paralysis. The face is innervated by the facial nerve which has 5 branches. Whenever the nerve is damaged, facial paralysis can result.
The typical features of facial paralysis include the following:
- Inability to raise the eye brow, blink or close the eyes
- Inability to smile or frown
- Increased salivation
- Drooping of the face
- Inability to taste food
- Sagging of the lips on the affected side
The diagnosis of facial paralysis includes use of some nerve tests and a CT scan or an MRI.
The facial nerve originates in the brain and the major trunk runs in front of the ear and then divides into 5 segments. The nerve can be affected anywhere along it course and result in facial hemiplegia.
The most common type of facial paralysis is called Bell’s palsy. The condition occurs abruptly and may result in the inability to control facial muscles on one side of the face. This facial palsy may come on rapidly and may last a few days. The cause of Bell’s palsy is a mystery and in most cases nothing is ever found. Bell’s palsy is usually treated with anti inflammatory drugs and sometimes anti viral medications. Drug therapies only work when treatment is started early but this is by no means standard therapy. Most people recover spontaneously without any treatment and achieve normal function of the face. Sometimes the recovery may take 10 days.
Other causes of facial paralysis include trauma of the face or brain. These individuals may also present with blood coming out of the ear, and may have perforation of the ear membrane and loss of hearing.
The other major cause of facial paralysis is infection with herpes zoster virus. These individuals present with painful vesicles near the ear, loss of hearing, feeling of imbalance and dizziness. The condition is treated with pain medications and anti viral drugs.
Sometimes an ear infection can spread and affect the facial nerve. This may present as ear pain, loss of hearing and paralysis of segments of the facial nerve. In rare cases, tumors of the brain and face can also cause facial nerve paralysis. In such cases, a CT scan or an MRI will reveal the presence of a mass
Another common case of facial paralysis is surgery. Sometimes a mass may be sitting on top of the facial nerve and during surgery the nerve may have to be removed or become damaged.
Like all nerve injuries, facial paralysis treatment is a time dependent process. Depending on the cause, drugs may be used to control pain or impingement on the nerve may have to be removed surgically. Sometimes if the nerve has been cut or removed, surgeons may repair or use various complex muscle nerve transfer procedures to restore the facial hemiplegia.