Facial Nerve Palsy

Facial Nerve Palsy

Facial nerve palsy occurs when there is damage to the seventh cranial (facial) nerve. It is a type of mononeuropathy. The seventh facial nerve is located in the skull. It controls movement of the muscles of the face. It also affects feeling in the ear canal and the sense of taste.

It most commonly occurs without obvious cause and is believed to be viral.

This type of nerve damage may also occur with local growths, such as a tumor, that put pressure on the facial nerve.

Facial nerve palsy may also be caused by:

  • HIV infection
  • Lyme disease
  • Sarcoidosis

It also may have no obvious cause.


  • Change in the appearance of the face
  • Difficulty closing one eye
  • Difficulty making expressions, grimacing
  • Difficulty with fine movements of the face
  • Facial droop
  • Paralysis of one side of the face
  • Difficulty eating (items fall out of the weak corner of the mouth)
  • Face feels pulled to one side
  • Face feels stiff
  • Headache
  • Impairment of taste
  • Increased loudness of sound in one ear
  • Pain behind the ear (for Bell’s palsy)
  • Sensitivity to sound (hyperacusis)

Exams and Tests

An examination will show facial drooping on one side of the face or just on the forehead, eyelid, or mouth. Examination of the eardrum may show fluid-filled sacs (vesicles).

A blood test may be done to check for Lyme disease. Other tests may include:

  • Lumbar puncture
  • MRI of the head
  • Tests to rule out a stroke or other nervous system problems


Finding and treating the cause (if it can be found) may relieve symptoms in some cases. The disorder may disappear on its own depending on the severity of nerve damage.

Powerful anti-inflammatory drugs (steroids) may be used if the condition is caught early enough. The drugs may be used in combination with an antiviral drug called acyclovir.

Your doctor may recommend lubricating eye drops or eye ointments to protect the eye if it doesn’t close completely. You may need to wear a patch over the eye while you sleep.

Your health care provider may recommend surgery to remove any tumors that are pressing on the facial nerve.