#facial nerve

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Mending with Merlin

Lips curve up, skin crinkles around the eyes and there it is – a smile. The facial nerve coordinates the muscles behind this gleeful expression. Damage to this peripheral nerve can cause facial paralysis. Thankfully peripheral nerves usually heal with time. However people with neurofibromatosis type II (NFII) show slower and sometimes incomplete recovery from facial paralysis – a consequence of surgery to remove the facial tumours that characterise this disease. NFII is caused by mutations in the gene encoding merlin protein. Researchers therefore investigated whether merlin is important for repairing damaged peripheral nerves. In normal mice and mice lacking merlin in their peripheral nerves (pictured), damaged nerves (green) grew back and established contacts (red) with the appropriate muscles. However despite this, mice lacking merlin didn't regain full control of their muscles. For NFII patients, getting those smiles back after surgery may therefore be hampered by the presence of mutant merlin.

Written by Lux Fatimathas

Image from work by Alexander Schulz and colleagues

Leibniz Institute on Aging, Fritz Lipmann Institute, 07745, Jena, Germany

Image originally published under a Creative Commons Licence (BY 4.0)

Published in PLOS One, July 2016

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Bell's Palsy: Understanding Sudden Facial Paralysis

Waking up to find one side of the face suddenly drooping, unable to close an eye fully or smile evenly, is one of the more frightening experiences a person can have, and it is entirely reasonable for the first thought to be stroke. Bell's palsy is a distinct condition that can produce very similar sudden facial paralysis, but it involves the facial nerve specifically rather than the brain, and distinguishing between the two quickly is essential for both proper treatment and peace of mind.

Dr. Raj Bhayani, an ENT and craniofacial surgeon at the New York Institute of Otolaryngology and Aesthetic Surgery in Brooklyn and Rego Park, evaluates Bell's palsy as part of a broader practice addressing conditions of the facial nerve. This guide explains what Bell's palsy actually is, how to recognize its symptoms, what causes it, the treatment and recovery process, and when facial paralysis could indicate something other than Bell's palsy.

What Bell's Palsy Is

Bell's palsy is a sudden, temporary weakness or paralysis affecting one side of the face, caused by dysfunction of the facial nerve, which controls the muscles responsible for facial expression. Unlike a stroke, which typically affects other functions such as speech or limb movement alongside facial weakness, Bell's palsy generally affects only the face and develops without the other neurological symptoms associated with a stroke.

The exact mechanism behind Bell's palsy involves inflammation and swelling of the facial nerve as it passes through a narrow bony canal near the ear, and this swelling compresses the nerve enough to disrupt its normal function. In most cases, this compression resolves over time as inflammation subsides, allowing the nerve to gradually recover its function.

Recognizing the Symptoms

Bell's palsy typically develops suddenly, often over the course of a few hours to a day, and produces a fairly recognizable pattern of symptoms on one side of the face.

Drooping of one side of the mouth, making smiling or speaking clearly difficult

Difficulty closing one eye fully, sometimes with increased dryness or tearing

Loss of the normal forehead wrinkles on the affected side

Changes in taste on the front portion of the tongue

Increased sensitivity to sound in one ear

A sensation of facial heaviness or mild pain around the jaw or ear before symptoms fully develop

Because Bell's palsy affects only the face and does not typically cause weakness in the arms or legs, slurred speech beyond what facial weakness alone would cause, or confusion, these distinguishing features are important for quickly differentiating it from a stroke, which requires an entirely different emergency response.

What Causes It

The exact cause of Bell's palsy is not always identified with complete certainty, but it is widely believed to be linked to viral infection and the resulting inflammation of the facial nerve.

Reactivation of the herpes simplex virus, believed to be a leading contributing factor

Other viral infections that can trigger similar nerve inflammation

Pregnancy, particularly during the third trimester, which carries a somewhat increased risk

Diabetes, which may increase susceptibility to nerve-related complications

Recent upper respiratory infection preceding the onset of symptoms in some cases

Because a specific virus or trigger is not always definitively identified in an individual case, treatment for Bell's palsy is typically focused on reducing inflammation and supporting nerve recovery rather than targeting a single confirmed cause.

Treatment and Recovery

Treatment for Bell's palsy typically begins as soon as possible after symptoms appear, since early treatment is associated with better recovery outcomes.

Oral corticosteroids, usually started within the first few days, to reduce nerve inflammation

Antiviral medication, sometimes added alongside steroids, particularly when a viral cause is suspected

Eye protection, including lubricating drops and sometimes a protective covering at night, to prevent damage from incomplete eye closure

Physical therapy or facial exercises in some cases to support muscle function during recovery

Most people with Bell's palsy begin noticing improvement within a few weeks, with the majority experiencing substantial or complete recovery within three to six months. A smaller percentage of patients experience longer recovery times or some degree of lasting facial weakness, which is why continued follow-up throughout the recovery period matters.

When It Could Be Something Else

While Bell's palsy is the most common cause of sudden facial paralysis, certain features should prompt immediate evaluation to rule out other, more serious causes.

Facial weakness accompanied by arm or leg weakness, which points toward a possible stroke

Slurred speech beyond what facial weakness alone would explain

Sudden confusion, severe headache, or vision changes accompanying facial symptoms

Facial weakness that develops very gradually over weeks rather than suddenly, which can suggest a different underlying cause

A prior history of cancer, which occasionally can involve the facial nerve in ways that mimic Bell's palsy

Any sudden facial weakness should be evaluated promptly, since distinguishing Bell's palsy from a stroke or other cause quickly is essential for ensuring the correct treatment begins without delay.

Choosing the Right ENT for Bell's Palsy

Bell's palsy can be a frightening experience, but the majority of patients recover well with prompt evaluation and appropriate treatment. Dr. Raj Bhayani has treated Bell's palsy in patients across Brooklyn and Rego Park, focusing on rapid evaluation to confirm the diagnosis and begin treatment as early as possible in the recovery window. For anyone experiencing sudden facial drooping or weakness, prompt evaluation offers the clearest path toward both an accurate diagnosis and the best possible recovery.

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বেলস পালসির লক্ষণ এবং উপসর্গ

বেলস পালসির লক্ষণ এবং উপসর্গ

বেলস পলসি হল মুখের পেশী দুর্বলতা বা পক্ষাঘাতের একটি অবস্থা । এটি হঠাৎ শুরু হয় এবং ৪৮ ঘন্টার মধ্যে খারাপ হয়। এই অবস্থা মুখের স্নায়ুর (৭-তম ক্র্যানিয়াল নার্ভ) ক্ষতির ফলে হয়। ব্যথা এবং অস্বস্তি সাধারণত মুখ বা মাথার একপাশে হয়। বেলস পলসি যে কোনো বয়সে যে কাউকে আঘাত করতে পারে। এটি প্রায়শই গর্ভবতী মহিলাদের মধ্যে ঘটে এবং যাদের ডায়াবেটিস, ইনফ্লুয়েঞ্জা, ঠান্ডা বা অন্য ঊর্ধ্ব শ্বাসযন্ত্রের অসুস্থতা…

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[geethahari]

VII Cranial Nerve - Facial Nerve

VII Cranial Nerve – Facial Nerve

Functional components Facial nerve has the following functional components • Special visceral efferent (SVE) fibres arise from motor nucleus and supplies the muscles derived from the mesoderm of 2nd pharyngeal arch, viz. muscles of facial expression, etc. • General visceral efferent (GVE) fibres are preganglionic parasympathetic fibres to the pterygopalatine and submandibular ganglia for…

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[meiwoscience]

Facial nerve and blood vessel branches. Facioplegia may cause loss of function of the corresponding expression muscles.

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missing yoongi hours open while reviewing facial muscles

[soup-spoonie]

Does anyone else have this weird extra pulse in their face in hot weather? It's usually when I'm overheated and it's a slower rhythm than my real pulse, unrelated to that or my breathing, but it's very regular in rhythm. I usually feel it in the tissues around my nose and mouth... Feels like swelling and unswelling in slow repetition.

I've talked about it with my sister, who is a pain therapist/massage therapist, and she forwarded the question to a discussion group that deals with facial nerves/issues. So far the consensus is that might either be a rise in BP or some kind of response in my facial nerves (which rise out of cranial nerves) more in response to the *stress* of being overheated than the heat itself. But I was also wondering if this is a common thing for people with POTS/dysautonomia? Hashimoto's disease?

Just wondering if anyone else has experienced this and/or if you have any answers? It's not painful or anything... but mysteries bug me!