Facial Palsy

Facial palsy can completely alter the function and appearance of a person’s face, affecting their confidence and wellbeing.

The eyelids and brow can have particular problems of poor eye closure, resulting in sore eyes with blurred vision. A low eyebrow and sagging eyelids are a cosmetic problem as well as functional issues including a watery eye.

Mr Uddin understands the importance of restoring the natural facial aesthetics, as well as the form and function of the eyes.

Working for over 20 years as an oculoplastic surgeon Mr Uddin has a wealth of experience in treating patients with facial paralysis. He has a comprehensive range of innovative techniques, both nonsurgical and surgical, to offer the best management for each person with this condition. This is combined with a whole team of radiologists, ENT, neurologists, plastic and maxillofacial surgeons to provide complete care.

What is facial palsy?

Facial palsy is the paralysis or weakness of the facial muscles due to damage or incomplete development of the facial nerves. This affects the movement of parts of the face, including the eyes and the mouth. It can affect one or both sides of the face.

What are the symptoms of facial palsy?

People with facial palsy may experience watery, gritty or sore eyes with blurred vision. They may be unable to close their eyes fully (especially at night) or blink and have a droopy eyebrow or lower eyelid. The corner of the mouth may also droop causing drooling, difficulty eating and speaking. Sometimes, just facial asymmetry is noticed, with the affected side not moving so well, or there a pull to the unaffected side. Other symptoms include ear pain, hearing loss and increased sensitivity to high pitched noise. Symptoms can appear suddenly or over a couple of days.

Abnormal tearing (esp with food) and eyelid/facial movements may indicate synkinesis when nerves recover but “wire up” incorrectly.

What causes facial palsy?

Facial palsy may be present from birth (congenital), as a result of a genetic syndrome or abnormal development of the facial nerve or muscle and occasionally forceps delivery,

In adults the most common cause of facial paralysis is Bell’s palsy, caused by a viral infection which affects the function of the facial nerve. Symptoms normally start suddenly, with a tingling sensation in the face or a mild earache. Within a short time period weakness or paralysis on one side of the face will occur. Approximately 75% of patients with Bell’s palsy recover without medical intervention, but should seek help early as treatment may help recovery.

Other causes of this condition include trauma to the facial nerve due to injury or surgery, bacterial infections such as Lyme disease or neurological conditions such as Neurofibromatosis 2. On rare occasions facial paralysis may be an indicator of the growth of a tumour on a cranial nerve, especially if there is hearing loss and numbness on the same side of the face.

What investigations will need to be carried out?

Photographs are often helpful to determine how long the palsy has been there. Mr Uddin carries out a full clinical examination of the eyes and face. Occasionally, neurological examinations and blood tests may be required. Other investigations such as an, electromyography, computerised tomography (CT) or magnetic resonance imaging (MRI) scans may be needed.

What treatments are available for facial palsy?

Treatment for facial palsy is determined by the underlying cause of the condition. Mr Uddin works with a specialist team of neurologists, oncologists, otolaryngologists (ENT), psychotherapists and speech & language therapists to provide a comprehensive treatment plan.

Botulinum toxin (Botox) and fillers

Another effective treatment is Botox therapy, in which Botulinum toxin (Botox) is injected into the muscles around the eye, relaxing them and improving facial symmetry or reduce synkinesis.

Steroids or an antiviral drugs

In some cases steroids or an antiviral drugs and steroids may be used to treat the condition, this may be used in conjunction with eye drops or an ointment to treat dry eyes.

Surgery

Surgery may be needed if the upper eyelid droops (ptosis), the eyelid turns outwards (ectropion), eyelid cannot close or if the eyes are watering excessively. The aim of the treatment is to improve eye function, preserve vision and restore the natural facial aesthetic.

Surgery for poor eyelid closure (Lagophthalmos) and eye protection
Brow and upper eyelid surgery
Eyelid loading/ upper lid weight/gold weight
Lower eyelid and midface surgery
Static facial surgery
Facelift
Dynamic Procedures
Speech Therapy

Speech Therapy is important for regaining control of the speech muscles through massages and exercises. As facial palsy can cause psychological stress and a loss of confidence, many patients also benefit from seeing a psychotherapist.

Contact us

Moorfields Private Outpatient Centre

9-11 Bath St EC1V 9LF
London (Central London)

Moorfields Private Practice

8 Upper Wimpole St W1G 6LH
London (Central London)

Parkside Hospital

53 Parkside SW19 5NX
London (Wimbledon)

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