Facial Nerve Problems and Bell's Palsy (Bell Palsy)

  • Medical Author:
    Danette C. Taylor, DO, MS, FACN

    Dr. Taylor has a passion for treating patients as individuals. In practice since 1994, she has a wide range of experience in treating patients with many types of movement disorders and dementias. In addition to patient care, she is actively involved in the training of residents and medical students, and has been both primary and secondary investigator in numerous research studies through the years. She is a Clinical Assistant Professor at Michigan State University's College of Osteopathic Medicine (Department of Neurology and Ophthalmology). She graduated with a BS degree from Alma College, and an MS (biomechanics) from Michigan State University. She received her medical degree from Michigan State University College of Osteopathic Medicine. Her internship and residency were completed at Botsford General Hospital. Additionally, she completed a fellowship in movement disorders with Dr. Peter LeWitt. She has been named a fellow of the American College of Neuropsychiatrists. She is board-certified in neurology by the American Osteopathic Board of Neurology and Psychiatry. She has authored several articles and lectured extensively; she continues to write questions for two national medical boards. Dr. Taylor is a member of the Medical and Scientific Advisory Council (MSAC) of the Alzheimer's Association of Michigan, and is a reviewer for the journal Clinical Neuropharmacology.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Bell's Palsy Symptoms

Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: Charles Patrick Davis, MD, PhD

Bell's palsy is a condition that affects the facial nerve, and therefore the function of the muscles, on one side of the face. The facial nerve is one of the 12 cranial nerves and is given the designation of the 7th cranial nerve (CN VII). There is a facial nerve on each side of the face. This nerve can be considered to be the nerve that controls facial expression, so when its function is disrupted, the control of facial expression is impaired.

While a number of different conditions can cause damage to the facial nerve, including tumors, trauma, toxins, and neurologic diseases, true Bell's palsy is an idiopathic (meaning that the cause is unknown) paralysis of the facial nerve. It typically occurs on one side of the face and comes on suddenly, sometimes overnight. The diagnosis of Bell's palsy is a diagnosis of exclusion, meaning that this diagnosis is made when all the potential other causes of nerve damage have been ruled out. Most investigators believe that Bell's palsy results from...

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Facial nerve problems and Bell's palsy facts

  • Facial nerve disorders affect the muscles of the face.
  • There are many causes of facial nerve disorders.
  • A number of tests can be helpful to diagnose the cause of a facial nerve disorder.
  • The treatment of a facial nerve disorder depends on the cause and severity.

What is the facial nerve?

The facial nerve is a nerve that controls the muscles on the side of the face. It allows us to show expression, smile, cry, and wink. Injury to the facial nerve can cause a socially and psychologically devastating physical defect; although most cases resolve spontaneously, treatment may ultimately require extensive rehabilitation or multiple procedures.

The facial nerve is the seventh of the twelve cranial nerves. Everyone has two facial nerves, one for each side of the face. The facial nerve travels with the hearing nerve (the eighth cranial nerve) as it travels in and around the structures of the middle ear. It exits the front of the ear at the stylomastoid foramen (a hole in the skull base), where it then travels through the parotid gland. In the parotid gland it divides into many branches that provide motor function for the various muscles and glands of the head and neck.

What are symptoms of a facial nerve problem?

Facial nerve problems may result in facial muscle paralysis, weakness, or twitching of the face. Dryness of the eye or the mouth, alteration of taste on the affected side, or even excessive tearing or salivation can be seen as well. However, the finding of one of these symptoms does not necessarily imply a specific facial nerve problem; the physician needs to make a careful investigation in order to make a precise diagnosis. Symptoms of a facial nerve problem can vary in severity depending upon the extent of the injury to the nerve. Symptoms may range from mild twitching to full paralysis of the muscles on one side of the face.

What conditions affect the facial nerve?

There are numerous causes of facial nerve disorder:

  • Trauma such as birth trauma, skull base fractures, facial injuries, middle ear injuries, or surgical trauma
  • Nervous system disease including stroke involving the brain stem
  • Infection of the ear or face, or herpes zoster of the facial nerve (Ramsay Hunt syndrome)
  • Tumors including acoustic neuroma, schwannoma, cholesteatoma, parotid tumors, and glomus tumors
  • Toxins due to alcoholism or carbon monoxide poisoning
  • Bell's palsy, which is also called idiopathic facial nerve paralysis (see below); this condition is sometimes associated with diabetes mellitus or pregnancy
Medically Reviewed by a Doctor on 11/6/2015

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