Evaluation and Management of Facial Palsy

Facial paralysis afflicts a significant number of individuals annually. Although Bell's palsy is the most common cause of facial paralysis, that diagnosis can be hastily made, and life-threatening conditions and appropriate treatments for other causes can be missed. Facial paralysis increases the risk of ocular damage and poor vision; hinders the ability to eat, drink, and speak effectively; and often results in a negative self-image. Aberrant nerve regeneration with facial spasm, synkinetic movement, and excessive tearing are long-term problems that also need to be managed. Proper diagnosis, evaluation of the deficits with physical examination and imaging when needed, and instituting proper multidisciplinary management early in the disease process will optimize patient care and reduce the risk of permanent injury and deficits especially involving the eye. Although every practitioner will not be able to address all the issues involved with facial paralysis patients, understanding what treatments and interventions are available will facilitate appropriate and early referral to centers that can provide comprehensive care for these patients.