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Physiotherapy for Facial Palsy

Medikoe Health Expert

Medikoe Health Expert

  Koramangala, bengaluru, karnataka, india, Bengaluru     Feb 9, 2017

   5 min     


As we progress through a day, we make several voluntary movements such as arching the brows, smiling, closing our eyes and movements of lip and cheeks. Yet, seldom do we realize that all of these movements are under the control of a nerve. Yes, cranial nerve 7 to be precise. And the startling fact is that any damage to this nerve could cause facial paralysis. 

What is facial Paralysis?

Facial paralysis is the loss of facial movement caused due to damage to the 7th cranial nerve or the facial cranial nerve. The face appears saggy or droopy and the facial muscles become weak. It can occur on either side of the face or both, at once.

Some common causes of a facial paralysis would be a severe head injury or trauma, a stroke or a neck or head tumor. It can appear suddenly like Bell’s palsy or gradually over a period such as the case of a tumor. It may last for a short time or a longer time period. 

Causes of Facial Paralysis

Bell’s palsy is the most common cause of facial paralysis. This condition causes inflammation of the facial nerve due to which muscles on one side of the face end up being droopy. There is no known reason as to why it occurs, but fortunately, most people suffering recover in about six months, completely.

A stroke is a more serious case of facial paralysis. A stroke can cause a facial paralysis when nerves controlling the facial muscles are damaged in the brain. Brain cells can be damaged as well.

A few other causes are any injury to the face or a skull fracture, an infection, a tumor, Lyme disease, autoimmune diseases, HIV, Ramsay-Hunt Syndrome, and Guillain-Barre syndrome. A temporary facial palsy can also occur when a baby is born, but 90 percent of babies recover completely without any treatment 

Facial Paralysis Symptoms

  1. Facial paralysis normally affects one side of the face although in rare cases it may affect both sides. If you experience weakness in your arms or legs as well as weakness on one side of your face, you should seek immediate medical attention. These symptoms grouped may indicate a stroke.

  2. Loss of sensation may mean you cannot feel your face when you touch it.

  3. Some types of facial palsy will affect sensation including pain, as well as facial movement. This may mean that the nerve which is responsible for sensation (trigeminal nerve) has been damaged as well as the facial nerve. The facial nerve controls movement, tear production, saliva production and taste.

Facial Paralysis Treatment

There are many ways of treating a seventh cranial nerve palsy. Medication, as well as physiotherapy, can help strengthen the facial muscles and prevent permanent damage. For incomplete recovery, cosmetic surgeries can be done to correct eyelids that don’t close fully or for correcting a crooked smile. Sometimes, the disorder may disappear on its own, depending on its intensity. The doctor may recommend powerful drugs and lubricating eye drops to prevent eye damage, as in Bell’s palsy, eyes remain open and it can cause the cornea to dry out. If there are any tumors, then a surgery also may be required.

For treatment, many patients choose physiotherapy. There are ways like bell’s palsy facial exercises, electrical stimulation, Kabat rehabilitation, and manual massage. During physiotherapy many types of exercises and simulations are performed, commonly bell’s palsy facial exercises, electrical stimulation, Kabat rehabilitation, and manual massage are done.              

Facial Paralysis Treatment Exercises

Facial exercises for Bell’s palsy involve performing different exercises for different groups of muscles throughout the face. Each exercise is fabricated such that it targets one muscle primarily. If your treatment is being handled by a physiotherapist, they will recommend exercises according to the level of your palsy. If not, think of all the different muscles in your face and exercise them from the top to bottom. Begin from frowning and go up to the chin.

These exercises aren’t to be performed with a lot of pressure about completing all of them. These are intended to train our mind more than they are to work for our muscles.

All of these exercises can be performed from the comfort of your home. Thrice in a day would be ideal for optimum stimulation. With advice from your physiotherapist, you can also go for electrical stimulation. In this, a small amount of electricity is passed with the help of electrodes to stimulate the muscles of the face. This method is mostly used when the face is almost paralyzed and in dire need of help. For this, you’ll need to visit a certified therapist who can guide you through and provide assistance. Massage can be done on the face like kneading, tapping and stroking for recovery.

Kabat Rehabilitation is another method of physiotherapy that is based on proprioceptive neuromuscular facilitation. During Kabat Rehabilitation diagonal and spiral mass movements are done along with pathologic reflexes. They include stretching, manual resistance, a reversal of antagonists and rhythmic stabilization. 


In most cases, the recovery happens within a few weeks or months, without any treatment. But in some cases, unfortunately, the condition exists for life and physiotherapy is done to prevent further damage. Facial paralysis exercises help Bell’s palsy patients increase muscle strength and coordination in the face. That way, Bell’s palsy patients can improve their ability to perform the following facial movements:

  • Jaw and mouth movements

  • Lip closure

  • Eye movements

  • Smiling

  • Frowning

  • Facial expressions

  • Forehead wrinkling

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Tags:  Cranial nerves, Physiotherapy, facial paralysis,paralysis,cranial nerves, facial palsy, facial paralysis

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