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

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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 7/26/2012

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