Overview
Facial palsy is a condition characterized by weakness or paralysis of the facial muscles, often on one side of the face. It can result from nerve damage, infections, trauma, or underlying medical conditions. In Korea, facial palsy is commonly managed in neurology, otolaryngology, and plastic surgery departments, combining medical therapy, rehabilitation, and surgical options to restore both function and appearance. Early intervention significantly improves recovery outcomes.
What is Facial Palsy?
Facial palsy occurs when the facial nerve (cranial nerve VII) is damaged or inflamed, disrupting communication between the brain and facial muscles. This leads to difficulties in facial expressions, blinking, and oral movements. Common types include:
- Bell’s palsy – sudden, temporary paralysis of unknown cause
- Ramsay Hunt syndrome – caused by shingles affecting the facial nerve
- Congenital facial palsy – present at birth
- Traumatic facial palsy – caused by injury or surgery
Symptoms
- Drooping of one side of the face
- Inability to close the eye completely
- Flattened smile or asymmetric facial expressions
- Loss of taste on the front two-thirds of the tongue
- Increased sensitivity to sound (hyperacusis)
- Facial twitching or spasms
- Pain around the ear or jaw
Causes
- Viral infections (herpes simplex, varicella-zoster)
- Trauma to the head or face
- Tumors compressing the facial nerve
- Stroke or neurological disorders
- Autoimmune conditions
- Surgical complications involving the ear or parotid gland
Risk Factors
- Diabetes and hypertension
- Age over 40 (higher risk of Bell’s palsy)
- Pregnancy (especially in the third trimester)
- Recent viral infections
- Family history of facial nerve disorders
Complications
- Permanent facial weakness or asymmetry
- Eye problems due to incomplete eyelid closure
- Synkinesis (involuntary movements of facial muscles)
- Difficulty with speaking, eating, or expressing emotions
- Psychological effects due to cosmetic changes
Prevention
- Early treatment of ear infections and viral illnesses
- Protecting the head and face from injury
- Regular monitoring of chronic health conditions like diabetes
- Prompt medical consultation at the first sign of facial weakness
Treatment Options in Korea
Diagnosis
- Physical and neurological examinations
- Electromyography (EMG) to assess nerve function
- MRI or CT scans to identify structural or tumor-related causes
- Blood tests for infections or autoimmune conditions
Medical Treatments
- Corticosteroids to reduce inflammation in Bell’s palsy
- Antivirals for viral infections like Ramsay Hunt syndrome
- Pain management with analgesics or neuropathic medications
- Eye protection with lubricating drops or patches
Surgical or Advanced Therapies
- Facial nerve decompression for severe cases or nerve compression
- Nerve grafts or transfers for chronic paralysis
- Botulinum toxin injections to correct synkinesis
- Reconstructive or plastic surgery for long-term functional and cosmetic restoration
Rehabilitation and Support
- Physical therapy and facial exercises to improve muscle strength and coordination
- Speech therapy if oral movements are affected
- Occupational therapy for daily living adjustments
- Psychological counseling for coping with appearance changes
