Facial drooping and crooked mouth are symptoms that many people often associate with stroke or paralysis-related diseases. However, in reality, there are other conditions that can suddenly cause facial drooping, weakness on one side of the face, and inability to move facial muscles as they should. This condition is known as “Hemifacial Paralysis” or “Bell’s Palsy”. If you have never heard of this before, it is important to get to know it a little because both you and your close ones are at risk of developing this condition without exception.
What is Hemifacial Paralysis and who is most at risk?
Hemifacial Paralysis, or Bell’s Palsy, is a condition caused by inflammation of the seventh cranial nerve, which controls the facial muscles. This directly affects the facial muscles’ function. The exact cause of the inflammation is unknown, but it is suspected to be viral. The highest risk groups include diabetic patients, pregnant women, overweight individuals, and those with weakened immune systems. Even healthy individuals can develop this condition if they do not get enough rest and their immunity weakens. Therefore, hemifacial paralysis is a common condition that everyone should be aware of because anyone can develop it.
What symptoms suggest hemifacial paralysis?
The clear warning sign of hemifacial paralysis is weakness in the facial muscles. One side of the face may not move well, unable to raise the eyebrow, close the eye completely, or the mouth may droop. Some patients may experience drooling while drinking. Some may feel pain behind the ear and at the back of the head before the facial weakness appears. Most cases occur suddenly and become more obvious within 1-2 weeks. If you notice these symptoms, you should see a doctor immediately for diagnosis because delaying treatment can worsen the condition and slow recovery.
How is hemifacial paralysis diagnosed with certainty?
Since the symptoms of hemifacial paralysis are similar to those of stroke and paralysis-related diseases, accurate diagnosis by a specialist is very important to plan appropriate treatment. The diagnosis process involves asking about the sudden onset of symptoms and conducting a physical examination. The difference between hemifacial paralysis and other conditions like stroke or paralysis is that the latter may have additional symptoms such as dizziness or weakness in the arms and legs, not just the face.
How severe is hemifacial paralysis and how is it treated?
The severity of hemifacial paralysis varies by patient. Some have mild symptoms, while others who delay treatment may experience severe symptoms that are harder to treat. Treatment varies depending on the degree of muscle weakness. Traditionally, treatment mainly involves medication, including steroids and antiviral drugs. Most patients gradually improve after medication, but recovery time varies, usually around 3-6 months. If symptoms do not improve after more than 2 months of medication, further tests such as MRI or brain X-rays are needed to check for nerve compression or tumors. Besides medication, electrical muscle stimulation is also used in treatment.
Faster recovery from hemifacial paralysis with electromagnetic stimulation
In addition to traditional treatment with medication and electrical stimulation, a new treatment method that speeds up recovery is electromagnetic stimulation. This method uses a device to send magnetic waves directly to the seventh cranial nerve to strengthen the muscles. There are two types of electromagnetic stimulation devices:
- Transcranial Magnetic Stimulation (TMS) which stimulates the brain directly, and
- Peripheral Magnetic Stimulation (PMS) which stimulates peripheral nerves. For hemifacial paralysis treatment, doctors use PMS.
What are the steps for treatment with electromagnetic stimulation? Treatment with electromagnetic stimulation for hemifacial paralysis is safe and requires little preparation. Doctors will first screen patients to exclude those who cannot undergo this treatment, such as patients with a history of epilepsy or those with implanted ear devices. After screening, treatment begins immediately. The device sends magnetic waves to stimulate the facial nerves, causing muscle twitching and movement. Each session lasts about 10-15 minutes, with continuous treatment for at least 5 sessions to see clear improvement. On average, it takes about 1 month, with 1-2 sessions per week, to achieve good results. However, recovery depends on the severity of muscle weakness and how early treatment starts.
Hemifacial paralysis can affect anyone, regardless of age or gender. The weaker the body and immune system, the higher the risk. Although it can be treated successfully, recurrence is possible. Therefore, maintaining good health for yourself and your loved ones, especially the elderly and patients, by getting enough rest and eating a balanced diet is important to reduce the risk. Additionally, monitoring for abnormal symptoms and facial drooping is crucial. If suspicious symptoms appear, see a doctor immediately for diagnosis and treatment. Early treatment leads to better recovery, while delayed treatment, especially in patients with related diseases and the elderly, reduces the chance of full recovery. Even after recovery, some may not regain 100% function.
Dr. Rudeerat Wattanawong
Neurologist and Stroke Specialist
Brain and Nervous System Center
Phyathai 3 Hospital
Dr. Jittima Aysanont
Rehabilitation and Physical Medicine Specialist
Brain and Nervous System Center
Phyathai 3 Hospital
