Disorders of the Facial Nerve (Bells Palsy)

Twitching, weakness, paralysis of the face, dryness of the eyes or mouth and disturbance of taste are symptoms of facial nerve problems. Abnormal movement or paralysis of the face can result from infection, injury, or tumors, the most common cause of facial weakness which comes on suddenly is referred to as “Bell’s Palsy.” This disorder is probably due to the body’s response to a virus: in reaction to the virus the facial nerve within the ear (temporal) bone swells, and this pressure on the nerve in the bony canal causes damage. In order to be sure that this is the cause of the facial weakness we perform a series of test. The most common test are:
   
 
  1. Hearing test: Determines if the cause of damage to the nerve has involved the hearing nerve, inner ear, or delicate hearing mechanism.
  2. Balance test: Evaluated balance nerve involvement.
  3. Tear test: Measures the eye’s ability to produce tears. Eye drops may be necessary to prevent drying of the surface of the eye.
  4. Imaging: A CT Scan (computerized tomography) or MRI (magnetic resonance imaging) determine if there is infection, tumor, bone fracture, or other abnormality in the are of the facial nerve.
  5. Electrical Test: Stimulates the facial nerve to assess how badly the nerve is damaged. This test may have to be repeated at frequent intervals to see if the disease is progressing.

The results of the diagnostic testing will determine treatment. If infection is the cause, then an antibiotic to fight bacteria or antiviral agents may be used. If simple swelling is believed to be responsible for the facial nerve disorder, then steroids are often prescribed. In certain circumstances, surgical removal of the bone around the nerve may be appropriate. Disorders of the facial nerve, including paralysis, are not rare and have a variety of causes. The appropriate diagnosis and treatment are very important to achieving the best possible recovery of facial nerve function.

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