What is facial droop?

Facial droop occurs when your facial muscles are not working properly. Your face may not look symmetrical, and you may have trouble moving your eyes and/or mouth.

Facial droop can affect one or both sides of your face.

What symptoms are related to facial droop?

The symptoms associated with facial droop depend on its cause.

Bell’s palsy symptoms usually appear quickly and gets better gradually. These symptoms may include:

• difficulty closing your eye or blinking on the affected side
• difficulty smiling or chewing food
• mild pain near your ear
• change in taste

Facial droop caused by a brain tumour normally develops slowly. A brain tumour can cause other symptoms including:

• headache
• loss of balance
• seizures
• loss of hearing or smell
• nausea or vomiting

In the case of a stroke, your facial droop will usually come on suddenly. Other muscles on one side of your body might also be affected. More stroke symptoms are:

• a severe headache
• a seizure
• blurred vision/changes in your vision
• being unable to lift one or both arms because they are weak and numb
• being unable to walk due to weak legs
• speech that is slurred or garbled

If you have any of the stroke symptoms above, no matter how long they last, call triple zero (000) immediately and ask for an ambulance. If calling triple zero (000) does not work on your mobile phone, try calling 112.

What causes facial droop?

Facial droop can be caused by conditions that:

• damage the nerves in your face
• damage to the part of your brain that sends nerve signals to your facial muscles

This damage can be temporary or permanent.

Bell’s palsy

If you are otherwise healthy, the most common cause of facial droop is Bell’s palsy. This occurs when the nerve in your face becomes inflamed. This is usually due to infection with a virus.

Bell’s palsy is usually temporary, but it could be up to a year before your face returns to normal.

Brain tumour

Facial droop can also be caused by a brain tumour. The tumour can press on your facial nerves.

Stroke

Stroke can also cause facial droop. A stroke occurs when blood is blocked from reaching the brain.

Other causes of facial droop

Sometimes babies are born with facial droop.

Other causes of facial droop can include:

• complications from surgery
• infection and inflammation, such as from Ramsay Hunt syndrome
• facial injury

When should I see a doctor?

Call triple zero (000) immediately and ask for an ambulance if you:

• suddenly experience facial droop
• experience symptoms of a stroke

Even if your symptoms quickly come and go, you should seek emergency care. Short lasting symptoms can be a sign of a transient ischaemic attack (a brief stroke-like attack). This can increase your risk of stroke.

If you experience facial droop that appears more gradually, see your doctor immediately, or go to your nearest emergency department.

How is facial droop diagnosed?

If you have facial droop, your doctor will examine your face and look at how it moves. They will also do a full neurological examination to rule out stroke or other neurological causes.

Your doctor may order tests to diagnose the cause of your facial droop, including:

• CT scan
• MRI scan

How is facial droop treated?

Treatment options depend on what is causing your face to droop.

If your facial droop is caused by a stroke, brain tumour or illness, your treatment will address that condition.

Bell’s Palsy is usually treated with steroids to reduce inflammation.

Sometimes, facial droop can get better without treatment.

If your facial droop doesn’t go away, it is possible to have surgery to:

• close your eyelid
• correct a lopsided smile

If you also have uncontrolled muscle movements in your face, botox injections and physiotherapy can help.

Can facial droop be prevented?

Facial droop caused by conditions such as Bell’s palsy cannot be prevented.

However, you can reduce your risk of stroke by:

• eating healthily
• exercising regularly
• not smoking
• managing any conditions that increase your risk of stroke, such as:
  • heart disease
  • high blood pressure
  • diabetes
  • high cholesterol
  • vascular disease

Complications of facial droop

People with facial droop can also experience problems with their:

• eyes
• hearing
• speech
• teeth
• eating and drinking

Talk to your doctor if you have any of these concerns, so they can refer you for support and counselling.

Eye complications

If you have facial droop, it is important to look after your eyes to prevent damage.

If your facial droop prevents you from shutting one eye, you will need to take steps to avoid complications.

• always wear sunglasses outdoors
• wear a patch to prevent things from getting in your eye
• use lubricating eye drops or ointments
• tape your eyelid shut when you go to sleep

Let your doctor know right away if you have eye irritation, pain or changes to your vision. They will probably refer you to an ophthalmologist (a doctor who specialises in eyes).

Resources and support

The Stroke Foundation can provide information and support to those recovering from a stroke.

If you need to know more about facial droop, or to get advice on what to do next, call healthdirect on 1800 022 222 to speak with a registered nurse, 24 hours, 7 days a week (known as NURSE-ON-CALL in Victoria).