Facial Nerve Institute

Facial expressions provide unique insight into a person’s emotions and are important for communication. The loss of facial expression can be a very upsetting condition, regardless of cause, duration, or age.

Facial paralysis occurs when there is loss of facial movement, and there are many causes of facial paralysis (more than 100!).  Some are present at birth (i.e. Mobius syndrome), some occur later in life, and facial paralysis may be unilateral (affecting one side of the face) or bilateral (affecting both sides).

Facial palsy is a complex condition. At St. Louis Children’s Hospital, we provide comprehensive care to children with facial paralysis through a multidisciplinary team approach. Initial consultation is often with the reconstructive surgeon, Dr. Alison Snyder-Warwick. Consultations with other teams may be beneficial including:

• Ophthalmology
• Speech pathology
• Physical and Occupational therapy
• Neurology
• Otolaryngology
• Developmental psychology

What are the Effects of Facial Paralysis?

The emotional and social implications of this facial difference can be immense, sometimes even greater than the physical consequences. The physical consequences of facial paralysis may include:

• Eye difficulties due to increased eye exposure. Eye irritation, excess tearing, blurred vision, corneal ulcers, and repeated infections may occur.
• The affected eye may have a larger or staring appearance.
• The affected portion of the face may droop, although this is less common in children.
• The nose may be partially collapsed on the affected side, making nasal breathing more difficult.
• In cases of paralysis on one side of the face (unilateral), the mouth is more crooked with smiling. The normal muscles pull the lips to the normal side with smiling.
• In cases where both sides of the face are affected (bilateral), the lips may not move at all.
• The affected lips have poor movement and support, which can result in difficulties with speech (especially sounds like “p” and “b”) or drooling.