Facial Palsy Information - Ebian Korean Medicine Clinic

There is no single cause. It often results from a problem with the peripheral facial nerve, but it can also appear with central causes such as stroke, so in the early stage the first step is to determine which it is.

Whether you can wrinkle your forehead is one reference, and we also check whether neurological symptoms such as limb paralysis or speech difficulty are present. However, please do not judge this yourself; first get evaluated by a neurologist or ENT specialist.

Ramsay Hunt syndrome follows a different course from typical facial palsy and needs separate explanation, and it is known to be more likely than Bell's palsy to leave sequelae. If you have blisters on the ear or face or severe pain, please get a detailed examination.

A study of about 2,500 cases observed without treatment reported that 71% recovered normal facial movement (Peitersen, 2002). However, about 29% in the same study had sequelae of varying degrees, and since progress differs from person to person, we recommend being seen early after onset.

The return of movement does not mean it is over. Sequelae such as stiffness, contracture, twitching, and synkinesis can appear later, so continued observation is needed.

They include contracture (stiffening of facial muscles), stiffness (pulling when making expressions), twitching around the eye or mouth, synkinesis (the mouth moving when you close your eyes), pain, and facial asymmetry (imbalance between the left and right sides).

Around 3 months is considered the boundary between the incomplete recovery stage and the sequelae onset stage. Recovery may appear to slow down, but it is a time to check the level of nerve degeneration and whether sequelae have begun, so a different approach from the early stage is needed.

After 6 months is regarded as the advanced sequelae stage. The goal at this stage is not to reverse early recovery but to minimize sequelae such as synkinesis, facial asymmetry, facial contracture, and facial twitching. It varies with the degree of damage, so we judge each case individually.

Twitching or left–right asymmetry can remain as sequelae of facial palsy, so we look at them together. However, they can also appear without a history of facial palsy, so we check where and how often they occur to distinguish the cause.

They are different symptoms. Trigeminal neuralgia is a nervous system symptom with recurring stabbing pain in a specific area of the face, distinct from facial palsy, in which movement becomes weaker.

It can recur. If facial palsy recurs or symptoms of several cranial nerves appear together, we recommend a detailed examination.

The eye may not close well, the forehead may not move, the corner of the mouth may droop, and speaking or eating may become uncomfortable. Changes in taste or pain behind the ear may also occur, so we check these in the initial assessment.

If the eye does not close completely, the cornea can dry out or be damaged, so eye protection together with an eye doctor's care comes first. We check how the facial muscles are used with photos of six facial expressions and an examination, and plan treatment based on the remaining function.

When facial asymmetry remains, we first check which muscles move and to what extent. The approach differs by how long it has been since onset and the degree of nerve damage, and we explain what is possible based on the findings.

If nerves reconnect to different muscles during recovery, the face may feel tight or unintended areas may move together. These are called contracture, stiffness, and synkinesis, and they need continued observation even after facial movement has returned.