If your face is droopy, you may have facial paralysis, which is a loss of facial movement due to nerve damage. Your facial muscles may appear to droop or become weak.

Facial paralysis can be caused by infection of the facial nerve, head trauma, tumors, and stroke.

In some cases, such as Bell’s palsy, it can come on suddenly. Other causes, like facial or neck tumors, can cause paralysis that comes on gradually.

Depending on the cause, the paralysis might last for a short or extended period of time.

Read on to learn more about facial paralysis.

The following are possible causes of facial paralysis.

Bell’s palsy

Bell’s palsy is the most common cause of facial paralysis. Every year, around 40,000 people in the United States experience sudden facial paralysis due to Bell’s palsy.

This condition causes inflammation of the facial nerve. This can make the muscles on one side of the face droop.

Experts don’t know exactly why Bell’s palsy happens, but some think it may be related to a viral infection of the facial nerve. Lyme disease is one of the most common causes in the U.S.

The good news is that most people with Bell’s palsy recover completely in about six months.

Stroke

Stroke, another cause of facial paralysis, is more serious.

Facial paralysis occurs during a stroke when nerves that control the muscles in the face are damaged in the brain. Depending on the type of stroke, damage to the brain cells is caused by either lack of oxygen or excess pressure on the cells.

Other causes

Other causes of facial paralysis or weakness include:

Some babies have temporary facial paralysis immediately after birth. However, most recover completely without treatment. You can also have facial paralysis at birth due to certain congenital syndromes, such as Mobius syndrome and Melkersson-Rosenthal syndrome.

The symptoms of facial paralysis depend on the underlying cause. In this section, we break down the possible symptoms associated with different conditions.

Bell’s palsy

While facial paralysis is often alarming, it does not always mean that you are having a stroke. Symptoms of Bell’s palsy can include a combination of:

  • facial paralysis on one side
  • loss of blinking control on the affected side
  • drooping of the mouth to the affected side
  • altered sense of taste
  • slurred speech
  • drooling
  • pain in or behind the ear
  • sound hypersensitivity on the affected side
  • difficulty eating or drinking

Stroke

People experiencing a stroke often experience the same symptoms associated with Bell’s palsy. However, a stroke usually causes additional symptoms, including:

  • changes in level of consciousness
  • confusion
  • dizziness
  • loss of coordination
  • seizure
  • changes in vision
  • weakness in arms or legs on one side of your body

Sometimes, people experiencing a stroke will still have the ability to blink and move their foreheads on the affected side. This is not the case with Bell’s palsy.

Since it is sometimes hard to distinguish between a stroke and other causes of facial paralysis, it is a good idea to get your loved one to a doctor quickly if you notice facial paralysis. If you think someone is having a stroke, seek immediate medical attention.

Be sure to discuss all your symptoms with your doctor, and share information about any other conditions or illnesses you may have.

Your doctor may also ask you to try to move your facial muscles by lifting your eyebrow, closing your eye, smiling, and frowning. Tests such as electromyography (which checks the health of muscles and the nerves that control them), imaging scans, and blood tests can help your doctor learn why your face is paralyzed.

The treatment for facial paralysis depends on the cause. This section explains treatment options for different conditions.

Bell’s palsy

The vast majority of people with Bell’s palsy will fully recover on their own, with or without treatment. However, taking oral steroids (such as prednisone) and antiviral medications immediately may aid your recovery. Speech and language therapy can also help strengthen your muscles and prevent permanent damage.

For those who don’t recover fully, cosmetic surgery can help correct eyelids that won’t fully close or a crooked smile.

The most significant side effect of facial paralysis is possible eye damage. Bell’s palsy often keeps one or both eyelids from closing fully. When the eye can’t blink normally, the cornea may dry out, and particles may enter and damage the eye.

People with facial paralysis should use artificial tears throughout the day and apply an eye lubricant at night. They may also need to wear a special clear plastic moisture chamber to keep the eye moist and protected.

Stroke

For facial paralysis caused by stroke, the treatment is the same as for most strokes.

If the stroke was very recent, you may be a candidate for a special stroke therapy that can destroy the clot. If the stroke happened in the past, your doctor may use medications to reduce risk of further brain damage.

Strokes are very time sensitive. If you think that you or someone else may be having a stroke, you should seek immediate medical attention.

Other facial paralysis

Facial paralysis due to other causes may benefit from surgery to repair or replace damaged nerves or muscles, or to remove tumors. Small weights may also be surgically placed inside the upper eyelid to help it close.

Some people may experience uncontrolled muscle movements in addition to paralysis. Botox injections that freeze the muscles, as well as speech and language therapy, can help.

Bell’s palsy and stroke are common causes of facial paralysis. Most people with Bell’s palsy will recover completely, even without treatment.

For people who have had a stroke, getting medical attention quickly can greatly improve the possibility of a full recovery with limited damage to your brain and body. Rehabilitation and preventative measures will vary depending on the type and severity of your stroke.