Types of facial nerve disorder

Facial nerve disorders can be caused by infection, injury or other conditions.

Symptoms

Facial nerve disorders can cause weakness on one or both sides of your face. You might lose your facial expressions, and find it difficult to eat, drink and speak clearly. It can also become difficult to close your eye and blink, which can lead to damage to your cornea.

Disorders caused by infection

Bell’s palsy

This is the most common cause of facial paralysis - around 80% of all cases. It's also known as idiopathic unilateral facial paralysis. 15% of patients have partial facial weakness.

We usually treat Bell's palsy with a course of steroids and advice on looking after your eyes, oral hygiene and facial rehabilitation. Most people (85%) recover completely in six to nine months.

Find out more about Bell's palsy on NHS Choices.

Ramsay Hunt syndrome

Ramsay Hunt syndrome is caused by a virus in the facial nerve, and is a more severe cause of facial paralysis. You may have blisters in your ears and on the roof of your mouth, as well as facial weakness. Less than half of patients will recover completely. We'll treat you with steroids, antiviral medication, and give advice on eye care and facial rehabilitation.

Lyme disease

This is a bacterial infection caught by being bitten by an infected tick. You may have a target-shaped skin rash before a range of other symptoms such as headache, fever or weakness. You might also have neurological symptoms, one of which is facial paralysis. We will start your treatment with antibiotics and eye care.

Read more about Lyme disease on NHS Choices.

Other causes

Trauma

A traumatic injury to your head or face is one of the most common causes of severe permanent facial paralysis. In particular, fractures through the temporal bone of your skull are commonly associated with injury to the facial nerve, as well as injury to the labyrinth leading to hearing loss and vertigo. We can use electrophysiological testing and imaging to find out how severe your injury is. We'll sometimes need to surgically decompress or graft the facial nerve. Soft tissue injuries, such as lacerations, can also damage the facial nerve. It's important to have these injuries seen and repaired correctly to give you the best chance of recovering.

Iatrogenic injury

Iatrogenic injury can occur during surgery on your head or face. The type of treatment you need will depend on the degree of injury to your facial nerve. In severe cases, we might need to repair the nerve. If this isn't possible, we'll look at other surgical options to restore movement or symmetry to your face. 

Skull base tumours

Tumours within the facial nerve, benign tumours close to and compressing the facial nerve, or malignant tumours invading the facial nerve may cause facial weakness. The tumours most commonly involved are acoustic neuroma, facial neuroma and tumours in the region of the parotid gland. These tumours may be accompanied with progressive or recurrent facial weakness and other symptoms such as hearing loss or a mass in your neck.

Neurological conditions

Guillain-Barre syndrome or a peripheral neuropathy (damage to nerves in your extremities such as hands, feet or arms) may present with weakness on both sides of your face. A stroke may also cause you to lose movement in the lower part of your face.

Find out more about Guillain-Barre syndrome on NHS Choices.