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Cranial Facial Nerve Disorders: What You Should Know

Medically reviewed by Diana Rose G. Tolentino, MD, MBA · Ear Nose and Throat · HMICare Clinic & Diagnostic Center

Written by Tracey Romero · Updated May 26, 2021

Cranial Facial Nerve Disorders: What You Should Know

Are you wondering what facial nerve and cranial base disorders are? To help you get a better understanding of these disorders, here is a quick look at what you need to know.

What is a Facial Nerve or Skull Base Disorder?

The facial nerve, which is the Cranial nerve VII or seventh cranial nerve, emerges from your brainstem from the side of your skull. It predominantly controls the face muscles and transmits taste sensations from your tongue.

When the facial nerve is not functioning normally, it could mean that you have a facial nerve disorder. All disorders are categorized by weakness, unusual movement, drooping, or paralysis of part or all of your face.

What Are the Symptoms?

No movement or weakness on one side or both sides of your face is a predominant symptom of a facial nerve disorder. This can cause a person to lose their ability to make facial expressions.

Additionally, people who have these symptoms may find it hard to speak clearly, drink, and/or eat. In some cases, it could make it hard to blink and close your eye, which could damage your cornea.

Some people may experience unusual twitching or other movements in their faces. If a tumor invades the nerve, other symptoms may include pain as well as numbness, or a lump/mass may be present.

What Are the Causes of Facial Nerve Disorders?

Facial disorders can vary in severity. You may also have a different type depending on the cause of the condition. Here is a quick list of common facial disorders and causes.

Bell’s Palsy

One of the most common causes of facial paralysis is Bell’s Palsy. Most people who have Bell’s Palsy may only experience temporary weakness as it tends to get better after a few weeks. People could fully recover after six months.

Bell’s palsy can occur at any age and there is no known cause. It is believed that it may be a reaction from a viral infection or a result of inflammation and swelling of a nerve that controls one side of your face muscles. However, it could affect both sides of the face in rare cases.

Lyme Disease

If an infected tick bites you, it causes a bacterial infection called Lyme disease. Lyme disease can also be the cause of facial nerve disorders.

The first symptom most people may get is a target-shaped skin rash. After that, they may get other symptoms like weakness, fever, headache, and neurological symptoms, which include facial paralysis.

Ramsay Hunt Syndrome

The virus that causes chickenpox also causes Ramsay Hunt syndrome. The virus can still live in your nerves even when the chickenpox passes. So it can reactivate after many years and affect the facial nerves.

A facial nerve near one of your ears may get a shingles outbreak and that could signal that you have Ramsay Hunt syndrome. It can also cause hearing loss in your affected ear and facial paralysis.


A very common cause of permanent and/or severe facial paralysis is a traumatic injury. Fractures through your skull’s temporal bone in particular are often associated with a facial nerve injury.

What Are the Risks?

The risks you may have if you have a facial nerve disorder depends on what caused it. For instance, if Bell’s Palsy was the cause, you may have the following risks:

  • Complete or partial blindness in an eye from scratching the cornea or excessive dryness from being unable to close the eyelid
  • Abnormal regrowth of your nerve fibers
  • Irreversible facial nerve damage
  • Some complications of Ramsay Hunt syndrome include:

    • Postherpetic neuralgia
    • Eye damage from facial weakness which can make it hard to close your eyelid
    • Permanent facial weakness and hearing loss (however most patients may only have this temporarily)

    How Do You Treat Facial Nerve Disorders?

    The treatment of a facial nerve disorder may depend on what caused it, your specific case, etc. Here are some common treatments you may need for common facial nerve disorders:

    A doctor may prescribe corticosteroids and antiviral medication for Bell’s Palsy. Physical therapy may be also recommended. In some cases, people may get plastic surgery to potentially restore facial movement and make the face look even.

    For Lyme disease, most people get eye care and antibiotics to treat their infection. People may get facial rehabilitation, eye care, antiviral medication, and steroids to treat Ramsay Hunt syndrome.

    How Do You Prevent It?

    It may be difficult to learn how you can prevent getting a facial nerve disorder. For instance, Bell’s Palsy has no known cause, so there is no proven way to prevent it.

    You can wear long pants, long-sleeved shirts, tall closed boots, etc. when you go into a place that may have infected ticks (ex. forests) to prevent Lyme disease. Using an insect repellent may also be helpful.

    As mentioned earlier, the same virus that causes chickenpox causes Ramsay Hunt syndrome, so getting vaccinations as children can reduce your chances of getting the virus. People who are 50 years old and above may also get a shingles vaccine.

    When You Should See a Doctor

    If you experience facial paralysis, pain, weakness, numbness, twitching, or tics, then it may be best to see your doctor right away. A doctor may perform a thorough physical exam to see if you have a facial nerve disorder.

    It would be best to seek medical attention immediately if you have symptoms of a facial nerve disorder. Most facial nerve disorder symptoms are from benign disorders, which could be more serious problems.

    Key Takeaways

    Recognizing the signs and causes of facial nerve disorders can help you know whether you need to seek immediate medical attention.

    Learn more about Peripheral Nerve Disorders here


    Hello Health Group does not provide medical advice, diagnosis or treatment.

    Medically reviewed by

    Diana Rose G. Tolentino, MD, MBA

    Ear Nose and Throat · HMICare Clinic & Diagnostic Center

    Written by Tracey Romero · Updated May 26, 2021

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