Facial nerve paralysis (facial nerve palsy)

Causes

What causes facial nerve paralysis?
There are a number of possible causes. 

Causes of congenital facial nerve paralysis

When facial nerve paralysis is congenital (present at birth), it may be related to:

• Moebius syndrome
• Asymmetric Crying Facies, a minor birth defect that causes a lopsided appearance of the lower lip because the muscle controlling the lip is weak or underdeveloped on one side
• Cayler cardiofacial syndrome, a very rare condition in which a child is born with both congenital heart defects and a weak or missing muscle that controls his lower lip
• Congenital Unilateral Lower Lip Paralysis, a condition in which one side of the child’s lower lip is weak
• hemifacial microsomia

However, it’s important to note that—most often—children are born with facial nerve paralysis (typically affecting one side only) that has no identifiable cause.

Causes of acquired facial nerve paralysis

Children can develop facial nerve paralysis later in life because of:

• certain medical disorders, including:
• Guillain-Barre syndrome
• Bell’s palsy, a disorder—often linked to the herpes virus—in which inflammation damages the muscles on one side of the face
• Ramsay Hunt syndrome, an infection of the herpes zoster virus (shingles) that compromises the part of the facial nerve near the ear
• Lyme disease
• sarcoidosis
• poliomyelitis (polio)
• trauma, especially skull fractures
• chronic or severe episodes of otitis media (infection of the middle ear)
• tumors that affect any part of the facial nerve

Signs and symptoms

What are the symptoms of facial nerve paralysis?
Symptoms may vary from child to child, but often include:

• asymmetric or “lopsided” appearance of the eyes, mouth or an entire side of the face
• excessive drooling
• food or liquid falling out of the child’s mouth when she tries to eat or drink
• difficulty closing the eyes/blinking
• inability to make normal expressions (smiling, frowning, raising the eyebrows)
• pain around or behind one ear
• excessive sensitivity to loud sounds