If you or someone you know suddenly develops a droopy face, you may be wondering what caused it. Facial drooping happens when you lose the muscle tone on either or both sides of your face. It is almost always one sided, though. You may be thinking in more serious terms like, stroke, but it isn’t always the case. While you should seek immediate medical attention if you have signs of a stroke, it is good to know the different causes of why your face may be drooping. This article explores some of the things that may be happening, some tips for dealing with it, and when you should seek medical attention.
What Causes It?
A droopy face is most often temporary due to an illness or injury. Sometimes, it can be more serious and permanent. The possible causes of facial drooping include:
1. Ear Infections
A middle ear infection that has reached into the mastoid bone behind the ear can cause serious health effects. An infection like this can sometimes cause the facial nerve to become paralyzed. This is due to swelling near the nerve. Quick and effective treatment with antibiotics will help relieve the inflammation and restore function to the facial nerve.
2. Bell’s Palsy
Bell’s palsy is a benign facial droop caused by swelling near the facial nerve. The cause is usually a mystery, but is often seen after a virus or injury to the face. This condition resolves on its own within six months. In some people, there may be some permanent drooping if there is significant damage to the facial nerve.
3. Skull or Facial Injury
An injury to the skull or face may cause a droopy face. It is most common in blunt head trauma, temporal bone fractures, or surgical trauma of the face. With facial injuries, most have a high probability of recovery if the facial nerve was not severed. In cases where the facial nerve is severed, surgical repair of the nerve may restore function.
Birth injuries can also cause face drooping in newborns. This is most often caused by the use of forceps in delivery. This stretches the muscles between the head and neck, traumatizing the facial nerve. In 90 percent of babies born with this condition, it resolves on its own completely. Some babies may require surgery to repair the nerve function.
4. Lyme Disease
Lyme disease is a bacterial infection caused by tick bites. Other symptoms include red “bullseye” rash, fever, and joint pain. The Lyme bacteria can cause facial drooping in about 11 percent of people who contract Lyme disease. Around 99 percent of those with facial drooping have full function of the facial muscles restored with antibiotic treatment for the Lyme.
5. Ramsay-Hunt Syndrome
This syndrome is actually caused by the same herpes virus that causes Chickenpox, the Varicella Zoster virus. It reactivates in the body and creeps into your facial nerve causing it to become paralyzed. It can often be mistaken for Bell’s Palsy. There are a few distinct symptoms of this syndrome including; ear pain, tinnitus, dizziness, and nausea. It usually resolves on its own, but steroids can be given to decrease inflammation if symptoms are severe.
6. Neck or Facial Tumor
A mass in the neck or facial area can place pressure on the facial nerve and cause facial drooping. Facial drooping can be caused by direct pressure of the tumor on the nerve, or damage to the nerve during surgery to remove the tumor. Most surgeons will do testing after surgery to make sure the nerve was not damaged. Tumor removal may also relieve pressure and restore the facial muscle tone.
7. Autoimmune Diseases
Both Guillain-Barre syndrome and Multiple Sclerosis can cause facial nerve palsy and facial droop. In Guillain-Barre syndrome, doctors have seen cases of one or both sides of the face drooping. This is caused by the cranial nerve being affected, and not the facial nerve. In Multiple Sclerosis, facial droop is often caused by MS lesions on the area of the brainstem that controls the facial nerve.
8. Basilar Meningitis
An infection in the spinal fluid, basilar meningitis, can affect the cranial nerve, causing facial drooping. This is usually seen with severe bacterial meningitis and not seen as often with meningitis caused by a virus. There are also other causes of inflammation of the spinal cord that can affect the cranial and facial nerves. Treatment depends on the actual cause, but most cases are reversed with proper treatment.
9. Stroke
A stroke almost always causes a droopy face on one side. This is caused by blockage of blood flow in the brain to the nerves that supply the facial muscles. It is a medical emergency and 9-1-1 must be called right away if there are other symptoms of stroke. These include weakness on one side of the body, slurred speech, trouble walking, dizziness, and lack of consciousness. The sooner treatment is rendered for a stroke, the better the chances for survival.
Any Ways to Help?
Since most cases of facial droop are caused by infection and/or inflammation in the body, your doctor may recommend antibiotics and/or steroids, depending on the cause. For a stroke, you will need immediate hospitalization and blood thinning medications. If all serious causes have been ruled out, there are some things that may be recommended to help:
- Neck and face massages
- Face exercises
- Eye drops on the affected side
- Good oral care
When to See a Doctor
If you have sudden facial drooping and other symptoms like weakness on one side of the body, dizziness, slurred speech, or lose consciousness call 9-1-1. If you have facial drooping without other symptoms and have signs of a viral or bacterial illness (fever, headache, nausea, etc.), call your doctor for an appointment right away.