Facial nerve weakness or paralysis needs immediate medical intervention! Our physicians have special training and expertise in diagnosing and managing facial nerve disorders.  The goal is to initiate treatment as soon as possible to eliminate the source of the nerve damage and to insure the best outcome possible. If you or someone you know is experiencing a facial nerve weakness or paralysis, call the Midwest Ear Institute at once and inform the office staff of your symptoms.

What is the Facial Nerve?

The facial nerve is a rather long nerve that delivers electrical impulses to all muscles of facial expression. Information passing along the fibers of this nerve allows us to laugh, cry, smile, or frown. When half or more of these individual nerve fibers are interrupted, facial weakness occurs. If the nerve fibers are irritated, movements of the facial muscles appear as spasms or twitching. The facial nerve also supplies the tear glands, the saliva glands, and the muscle of the stapes (stirrup) bone in the middle ear. It also transmits taste from the front of the tongue.

Facial Nerve Anatomy

The facial nerve passes through the base of the skull in transit from the brain to the muscles that control facial expressions. After leaving the brain, the nerve enters the temporal bone through the internal auditory canal, a small bony tube, in very close association with the hearing and balance nerves. Along its inch-and-a-half course through a small canal within the temporal bone, the facial nerve winds around the three middle ear bones, in back of the eardrum, and then through the mastoid (the bony area behind the part of the ear that is visible).

After the facial nerve leaves the mastoid, it passes through the salivary or parotid gland and divides into many branches. The facial nerve has four components with several distinct functions: facial expression, taste sensation, skin sensation, and saliva and tear production.

Facial Nerve Paralysis Symptoms

Facial nerve paralysis can appear as sagging, frozen expressions, frowns, droopiness, and other surprising looks. Some patients report a typical day of waking up and feeling normal, then being shocked when looking in the mirror and seeing how one side of their face has changed. In others, Bell’s palsy takes a few days to fully develop, before changes in the face stop. Some people have a hard time eating or drinking due to the facial weakness. Other symptoms may include: facial numbness, drooling, pain around the ears, and loss of the sense of taste. Eyelids may not fully close and the face may feel heavy.

Facial Nerve Paralysis Causes and Risk Factors

Infections, injuries, or tumors can cause facial nerve disorders, but the most common cause of facial weakness is Bell’s palsy.

Bell’s palsy is a specific condition of nerve swelling that causes the facial nerve not to work, resulting in paralysis and distortions of the face. Bell’s palsy occurs when the facial nerve becomes damaged, through no known fault or action of the patient. The facial nerve is believed to have been squeezed or somehow swollen by an inflammation. There is no reason why the facial nerve becomes weak or why some people are more affected than others. Some studies have found that Bell’s palsy may be related to a virus or could be a response by your body’s immune system. Bell’s palsy is more common in the 15 to 45 year age group, those who are pregnant, have severe preeclampsia, are obese, have high blood pressure, diabetes, or upper respiratory ailments.


Bell’s palsy is diagnosed in several different ways. It is important that a doctor rule out other, non-Bell’s conditions that may be causing the facial paralysis or other symptoms. Your primary care physician or the expert physicians at the Midwest Ear Institute can review your symptoms and medical history to decide if conditions such as stroke, certain tumors, Lyme disease, infection, injury/trauma, or other disorders might be causing the paralysis. They will suggest proper testing and treatment after evaluation.

Early Intervention

It is important to quickly seek medical attention after the onset of symptoms. Seeking quick medical care will help avoid misdiagnosis or delayed diagnosis and may improve your chances of treatment. If your eyelids are not fully closing, it is very important to hydrate the eye. You can use eye ointment or eye drops to avoid any long-term harm to your sight. You should also protect your eyes. With Bell’s palsy, you are more prone to scratches of the cornea, which can be prevented by wearing an eye patch. If you are in pain, seek medical attention.


Several treatment options are available to Bell’s palsy patients. Some people will recover over time without seeking treatment. It is important to seek medical attention to discuss a treatment plan and avoid misdiagnosis. Some people benefit by taking prescribed oral steroids—and it may help to get this treatment soon after the onset of Bell’s. You may be prescribed antiviral drugs, though some studies do not support their benefit. There is conflicting evidence about how well some surgical and experimental treatments work. Call the expert physicians at the Midwest Ear Institute to discuss your condition and the risks and potential side effects with any treatment.

Prognosis and Expectations

The recovery time and severity of symptoms will vary among individuals, but most people affected by Bell’s palsy will recover over a period of time. According to most studies, facial function is completely restored in about 70 percent of Bell’s palsy patients with complete paralysis within six months, and as high as 94 percent of patients with partial paralysis. Some patients will recover in as little as a few weeks or months. There are a few others who may have some degree of long lasting paralysis.

The paralysis is likely to affect only one side of the face, but in rare cases it affects both sides of the face at once. Bell’s palsy may last from two to three weeks or longer. An early sign of improvement, such as getting a sense of taste back, is often a good indication that there will be a complete recovery. Usually the first return of facial nerve function is the lower lip.

Facial nerve palsy symptoms may make some people want to limit their time with other people due to their face looking different or distorted. Other people may have symptoms that affect their speech, vision or hearing. Some people have reported feeling faint or dizzy, conditions that can interfere with their daily activities.

Other Treatments

If your condition does not improve over time, there are further options and procedures that can help you treat your symptoms and reduce the effects of facial palsy. For instance, you can get specialized help with closing the eye. It is also very important that you watch your mental health and that you seek counseling or support if you feel overwhelmed by the way your face has changed. You need close follow-up with your doctor should your symptoms not get better within three months or if symptoms worsen.


In today’s world of social media, there are a number of websites with patients who are sharing life stories and pictures or videos of how they have coped- often with creative humor and good spirit, and how their condition has improved over time. We do not endorse any specific Bell’s related website and some sites have bad information. However, you may find comfort in joining online support discussion forums. These online forums offer a place where you can learn and share with others with Bell’s, who understand what you are going through. These sites can provide encouragement, useful coping tips, and hope.