Sixty-five-year-old Mr. Chan discovered one morning while brushing his teeth that he couldn’t close his left eye, and saliva was uncontrollably dripping from the right corner of his mouth. Looking in the mirror, he noticed half of his face was asymmetrical, leading to panic, "Oh no, is this a stroke? How will I meet my friends later?" The awkward social scenarios flashed through his mind. After seeking medical help, he was diagnosed with Bell's Palsy. Mr. Chan's experience is a reality for many facial paralysis patients.
In fact, facial paralysis can be differentiated from a stroke, and more importantly, most cases have a critical treatment window known as the "golden 72 hours". Whether you seek proper medical assistance in time significantly affects your recovery speed and extent.
This article, with insights from Dr. Lee, a Specialist in Otorhinolaryngology (ENT) at Chiron Medical, will break down the causes, symptoms, golden treatment period, and treatment options for facial paralysis, helping you make informed decisions during critical moments.
Facial paralysis, medically referred to as "facial nerve palsy", occurs when the seventh cranial nerve (the facial nerve) that controls facial expression muscles is damaged or inflamed, disrupting the signals sent to facial muscles.
Dr. Lee points out that Bell's Palsy is the most common type, accounting for about 70% of facial nerve paralysis cases. Patients may experience loss of muscle control in the forehead, eyes, and mouth, heightened sensitivity to sound, altered taste or loss of taste, increased tears, inability to raise eyebrows, difficulty closing the eyes, and drooling.
The exact cause of facial paralysis is unclear, but it is widely thought to be related to an overreaction of the immune system following a viral infection, attacking the facial nerve. Additionally, if the varicella-zoster virus (commonly known as the shingles virus) invades the facial nerve, it can cause a condition known as Ramsay Hunt Syndrome. Patients with Ramsay Hunt Syndrome often experience severe ear pain, blisters around the ear, and may have hearing loss or dizziness. Other structural causes, such as complications from otitis media (like cholesteatoma), head or facial trauma, or tumors compressing the facial nerve, are less common but should not be overlooked.
Dr. Lee adds that facial paralysis can occur in individuals of any age or gender, although it is more prevalent in the elderly. Pregnant women, individuals with diabetes, hypertension, or those with weakened immune systems are at higher risk.
According to Dr. Lee's clinical experience, the onset of facial paralysis is typically rapid, with symptoms peaking within 1-3 days.
He emphasizes: “The first 72 hours after onset is the golden period for treating facial paralysis!” During this time, appropriate medication can effectively suppress nerve inflammation and swelling, protecting nerve cells from permanent damage and significantly increasing the chances of full recovery.
If the golden treatment window is missed, or if the condition is severe, patients may face troubling long-term effects, such as:
The duration of symptoms varies among individuals. Most Bell's Palsy patients see significant improvement or full recovery within weeks to months with timely treatment, but the quality of recovery is closely related to whether the golden treatment window was utilized.
Dr. Lee continues, noting that the primary task of an ENT specialist is to conduct detailed examinations to rule out any facial paralysis caused by structural issues in the ear (such as otitis media, cholesteatoma, or acoustic neuroma). During the diagnosis, ENT specialists typically perform:
Treatment plans depend on the underlying cause. Doctors may opt for:
A: The recurrence rate for facial paralysis is low, around 7%. If recurrence occurs, further examinations are recommended to rule out underlying structural issues.
A: Since most causes are unknown, there is no guaranteed prevention method. Adequate sleep, a balanced diet, and stress management are beneficial for overall health and may reduce the risk.
A: There is currently no sufficient scientific evidence to suggest that "drafts" directly cause facial paralysis. The underlying cause is nerve inflammation, and rapid temperature changes may act as a trigger when the body's resistance is low, rather than being the root cause.
A: Like Mr. Chan, you can look in the mirror and try three facial expressions: 1. Raise your eyebrows and wrinkle your forehead; 2. Close your eyes tightly; 3. Smile widely. Observe whether both sides of your face are symmetrical; this is a simple preliminary assessment.
A: Stroke patients can also exhibit facial drooping, but a key distinguishing factor is the forehead:
However, this is a preliminary reference and not a substitute for professional diagnosis. If symptoms arise, seek immediate medical attention.
A: During treatment, acupuncture or physical therapy may be beneficial. To prevent facial muscle atrophy, patients should engage in physical therapy to stimulate and awaken the paralyzed muscle memory.
After recovery, some patients may experience facial spasms. It's recommended to perform facial exercises like frowning, closing eyes, smiling, and puffing cheeks to prevent atrophy on the affected side and promote recovery.
Facial paralysis is not untreatable. The key is accurate identification and timely medical intervention. Seize the golden treatment window of 72 hours to avoid permanent complications.
Updated: 2025-09
Disclaimer: The health information on this website has been reviewed by doctors from Kai He Medical Group. The content is for reference only and should not be considered medical advice or a substitute for consulting qualified healthcare professionals regarding personal health issues.
