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Facial Nerve Paralysis

When facial weakness and paralysis affect your ability to chew and smile or even impact your appearance, you can turn to our specialists to strengthen facial muscles. Facial nerve paralysis can be something you're born with or be linked to conditions like Bell's palsy, a brain tumor or stroke.

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Express yourself again

We use our faces to communicate what we're feeling — a soft smile to show appreciation for a loved one or a furrowed brow because we're upset.

Not only can facial paralysis and weakness make it more difficult to express these emotions, but it can take a toll on your everyday activities like eating, drinking and even blinking. No matter what caused your condition, we'll tailor treatments to help you feel and look like yourself again.

Lester Leung, MD, Director, Comprehensive Stroke Center at Tufts Medical Center; Director, Stroke and Young Adults (SAYA) Program, and Adedayu Dansu, Stroke Coordinator, adult neurology, discussing brain scans, condition with patient.
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Facial paralysis and weakness can happen for a variety of reasons. Some people are born with paralysis, while others deal with it later in life.

Look out for several early warning signs of facial paralysis, like:

  • An asymmetric or "crooked" smile
  • Eyebrow drooping
  • Inability to completely close the eye
  • Nasal blockage
  • Pain around the jaw or ear

Treating facial paralysis starts with understanding what caused it. Conditions that can cause facial paralysis include:

Autoimmune diseases
Bell's palsy
Complications related to a prior surgery
Neurologic or metabolic disease
Trauma to the temporal bone or face


Some common tests we run to determine the cause of your facial nerve paralysis include:

  • Blood work
  • CT scan
  • Electromyogram (EMG)
  • Electroneuronography (ENoG)
  • MRI


Facial nerve paralysis is often the symptom of another condition, so we'll collaborate with our colleagues in other departments to fully care for your needs.

For moderate paralysis

If your facial paralysis is something that started recently, we'll prescribe steroids and antiviral medications as soon as possible to reduce inflammation and prevent infection.

And if your paralysis prevents you from blinking, we can prescribe eye drops or lubricating ointment to keep your eyes hydrated.

Difficulty closing your eyes can be particularly frustrating at bedtime. We'll share a few tips and tricks you can perform yourself, like eye taping, to help you drift off to dreamland again.

For chronic or severe paralysis

If your facial paralysis persists, we'll work together on a long-term solution to help you look and feel your best.


The following treatments only take a few minutes to complete and will have you looking and feeling like yourself again in no time:

  • Botox® injection for abnormal facial movements or spasms
  • Filler injection to restore facial symmetry

Minimally invasive surgery

We can often correct moderate to severe cases of facial paralysis with minimally invasive surgery. These quick outpatient treatments only call for a small incision:

  • Eyebrow elevation
  • Eyelid laxity tightening
  • Eyelid weighting
  • Forehead lift
  • Static fascia sling of the face

Surgery for facial motion restoration

If you're dealing with severe or permanent facial paralysis, restoring basic functionality is our main goal. In many cases, we can perform surgical procedures that restore facial motion.

If your paralysis began less than 2 years ago, we'll work to transfer or reconnect nearby nerves to the facial nerve to help you do things like chew and use your tongue again.

If the paralysis started more than 2 years ago, we may have the opportunity to take parts of functional muscles from elsewhere in your body and repurpose them for your face. The most common forms of these surgeries include:

  • Gracilis free tissue transfer
  • Temporalis tendon transfer 
Anasuya Gunturi MD, PhD talks with patient at Lowell General Hospital's Women's Wellness Center clinic appointment.
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Lester Leung, MD (Director, Comprehensive Stroke Center; Director, Stroke and Young Adults (SAYA) Program), Cara Clifford, MA CCC-SLP (speech language pathologist) and Ali Daneshmand, MD (Neurology senior resident) discussing a case in the Neuro Trauma Unit at Tufts Medical Center.
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