Facial nerve palsy factsheet

Introduction 

Facial nerve palsy is when the facial nerve does not work properly. A person in unable to move the muscles that control smiling, blinking, speech and other facial movements. 

This condition can affect a person's ability to express emotion and communicate. Most of the time, facial nerve palsy is limited to one side of the face.

It usually happens because of congenital anomalies, trauma, or infections. It can significantly impact overall quality of life.

 Signs and symptoms

These are the most common symptoms:

  • Disordered movement of the muscles that control facial expressions, such as smiling, squinting, blinking, or closing the eyelid
  • Loss of feeling in the face
  • Tearing
  • Drooling
  • Pain around the jaw or pain in or behind the ear on the affected side
  • Increased sensitivity to sound on the affected side
  • Headache
  • Loss of taste.

The symptoms may look like other conditions or medical problems. Always see your healthcare provider for a diagnosis.

Diagnosis

The doctor will do a physical test and ask you to move your facial muscles. They may ask to close your eyes, lift your brow, show your teeth and frown, or make other movements or expressions. 

If the cause of  symptoms isn't clear, the doctor  may recommend other tests, including CT or MRI scans rule out other conditions that can cause similar symptoms and to determine the extent of nerve involvement or damage.
 

Treatment

Surgical interventions may include nerve grafts, where a healthy nerve is harvested from elsewhere in the body and used to link the facial nerve branches on the unaffected side with the side that is affected by the palsy. 

Muscles can then be transferred (usually from the inner thigh) to be powered by this nerve graft. Other options include powering muscles using unaffected nerves on the same side of the face. 

The  process will be tailored to the child's unqiue needs. 

 Management

The ultimate goal of facial nerve reconstruction in children is to restore facial symmetry. 

Rehabilitation is a crucial component of facial nerve reconstruction, involving physiotherapy and targeted exercises to enhance muscle strength and coordination. 

Emotional and psychological well-being is an important consideration to support the child through the treatment and rehabilitation process. 

Resources and more information

Healthdirect provides free, trusted health information and advice, 24 hours a day, 7 days a week online or via telephone 1800 022 022. 

Last updated Monday 6th May 2024

Disclaimer

This factsheet is provided for general information only. It does not constitute health advice and should not be used to diagnose or treat any health condition.

Please consult with your doctor or other health professional to make sure this information is right for you and/or your child.

The Sydney Children’s Hospitals Network does not accept responsibility for inaccuracies or omissions, the interpretation of the information, or for success or appropriateness of any treatment described in the factsheet.

© Sydney Children’s Hospitals Network 2024


This factsheet was produced with support from John Hunter Children's Hospital.