Facial Nerve Disorders


Facial nerve disorders are the result of damage to the nerves that control facial expression and movement. Facial weakness or paralysis can occur following a stroke, surgery, trauma, viral infection, or as the result of a tumor.

Bell’s Palsy

Damage from a viral infection causes facial nerve paralysis known as Bell’s palsy. Symptoms of this nerve disorder typically include

  • Weakness or paralysis that occurs on only one side of the face
  • Altered taste sensation on the affected side of the face
  • Increased sound sensitivity and pain behind the ear on the affected side
  • Increased tearing on the affected side

The majority of Bell’s palsy cases resolve without complication when the infection goes away. Up to 90 percent of patients regain normal function within a few weeks to months. Early diagnosis and treatment with antiviral medications and corticosteroids can improve the chances of a successful recovery.

Facial Spasms

Pressure from a blood vessel or an irritated nerve can cause the muscles of the eye or face to spasm. A minimally invasive treatment using Botox injections can alleviate the spasms by relaxing the muscles and nerves. In some circumstances, the blood vessel putting pressure on the nerve may need to be surgically removed.

Ramsay Hunt Syndrome

This disorder is the result of damage to the facial nerve caused by the shingles virus. Shingles is caused by the same virus that causes chicken pox and is characterized by a painful, blistering rash that normally appears on one side of the body. Ramsay Hunt syndrome can occur when the rash attacks the nerves in and around the ear. The disorder is treated in the same manner as Bell’s palsy. Approximately 50 to 60 percent of patients regain normal function following treatment.

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A neuroma, also known as a facial schwannoma, is a type of slow-growing tumor that can cause facial paralysis when it involves the facial nerves. Observation is often the first course of action, since the tumor may not grow to the point of causing paralysis. If paralysis does occur, treatment normally involves surgery to restore facial tone and movement by removing the tumor and replacing the damaged nerve with one grafted from elsewhere in the body. Depending on the location of the tumor, stereotactic radiation may be used to keep the tumor from growing without having to remove it surgically.


Facial weakness or paralysis can occur when an accident or another type of trauma damages the bones and nerves around the ear. Treatment options vary based on the location, type, and severity of the injury.

Diagnosing Facial Disorders

Specialists in otolaryngology use a number of different tests to determine the cause and the extent of facial nerve damage, including electroneuronography, electromyography, CTs, and MRIs. Because facial nerve disorders are complex and can involve nerves that affect sight and hearing as well as facial muscles, a multi-disciplinary treatment approach is often necessary. Depending on the patient’s specific condition, the treatment team may include neurologists, neurosurgeons, audiologists, ophthalmologists, plastic and reconstructive surgeons, and head and neck surgeons.