Who treats facial nerve palsy?
Facial nerve paresis is a damage of a nerve. Therefore, it should be treated by a neurologist, i.e. a doctor of neurology. Occasionally, patients with facial nerve palsy first go to a general practitioner because they do not know exactly how to classify these symptoms. The family doctor can then issue a referral for a neurologist. Depending on the cause, the neurologist can also consult an ear, nose and throat specialist if necessary, for example in the case of a tumor disease.
I recognize facial nerve palsy by these symptoms
Facial nerve palsy usually causes relatively impressive symptoms, which is why this nerve paralysis can often be easily recognized as such. Occasionally, however, the damage is only very slight, so supportive tests can be helpful in identifying the symptoms. In most cases, facial nerve palsy only occurs on one side.
In so-called peripheral facial nerve palsy, the affected person has a drooping corner of the mouth in one half of the face, cannot turn up his nose properly and cannot inflate his cheek. Depending on the extent of the damage, the peripheral damage can be accompanied by disturbances of taste in the front two thirds of the tongue, since the facial nerve is also responsible for this. Saliva production may also be reduced.
Other possible symptoms of peripheral facial nerve palsy are excessive hearing sensitivity and a reduction in tear secretion. However, these symptoms are usually not perceived as strongly as the loss of movement of the facial muscles. In so-called central facial nerve palsy, the forehead can no longer be wrinkled and the eye can no longer be closed properly.
The latter can quickly become dangerous, as the eye can dry out as a result. Pain is not one of the classic symptoms of facial nerve palsy, but it can certainly occur. Often they are located in the area of the ear and the parotid gland, if the facial nerve is damaged in its course near the auditory canal.
If these occur together with a painful rash in the auditory canal, a so-called Ramsay-Hunt syndrome should be considered. This is caused by herpes viruses and should be treated accordingly. Furthermore, pain in the area of the eye can occur in the case of a so-called central facial nerve paresis.
The reason for this is the non-functioning eyelid closure, which creates a danger of drying out. This can be very painful for the eye and should therefore be treated promptly. Occasionally, headaches can also occur in facial nerve palsy.These occur mainly in central facial paresis and can also be accompanied by cramps.
When headache occurs in combination with facial nerve palsy, depending on the other accompanying symptoms, imaging, such as a CT or MRI, should be performed for clarification. This is necessary to ensure that there is no malignant or acutely threatening cause, such as a tumor or trauma.
