Facial Paralysis: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Facial Paralysis?
A neurologist, a doctor who treats nerve and brain conditions, often leads care for facial paralysis. An ENT doctor (ear, nose, and throat) or a facial plastic surgeon may also help. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is facial paralysis?
Facial paralysis means a person cannot move some or all of the muscles on one or both sides of the face.
It is often caused by damage or swelling of the facial nerve, which carries signals from the brain to the muscles of the face. In people who are otherwise healthy, it is often due to Bell palsy, a condition in which the facial nerve becomes inflamed.
Symptoms
Bell palsy is the most common cause of facial paralysis. Its symptoms usually start suddenly, and may take 2 to 3 days to fully develop. They are almost always on one side of the face. Common signs include:
- Sudden weakness or paralysis on one side of the face.
- Drooping of the face, such as the eyelid or corner of the mouth.
- Drooling from one side of the mouth.
- Trouble closing one eye, which causes eye dryness.
- Trouble eating and drinking, because food falls out of one side of the mouth.
- Slurred words because of lip weakness.
Causes and who gets it
Facial paralysis is almost always caused by damage or swelling of the facial nerve, damage to the area of the brain that sends signals to the facial muscles, or muscle weakness from nerve and muscle diseases such as myasthenia gravis. Other causes include:
- A stroke, which may cause facial paralysis that comes on rapidly. Other muscles on one side of the body may also be involved.
- A brain tumor, which usually causes paralysis that develops slowly.
- Injury to the baby during birth, in newborns.
- Lyme disease, sarcoidosis (an inflammatory disease), or an infection of the brain or nearby tissues.
- A tumor that presses on the facial nerve.
- Side effects of medicines, such as botulinum toxin.
The cause of Bell palsy is often not clear. A herpes infection might be involved. Diabetes and pregnancy may raise the risk.
How doctors diagnose it
Often, Bell palsy can be diagnosed from a health history and a complete physical exam alone. There is no specific lab test that confirms Bell palsy.
Tests may be used to look for other causes. They include:
- Blood tests, including blood sugar and a test for Lyme disease.
- A CT scan or MRI of the head, which are scans that take detailed pictures.
- Electromyography (EMG), a test of the facial muscles and the nerves that control them.
Treatment
Treatment depends on the cause. For Bell palsy, often no treatment is needed. Medicines may improve the chances of recovery, but they must be started right away. Corticosteroids may reduce swelling around the facial nerve. Sometimes antiviral medicines (medicines that fight viruses) are added. Oral steroids should usually be started within three days of when symptoms begin.
If you cannot close your eye fully, protect it. Lubricating eye drops or ointment keep the eye moist, and an eye patch may be needed while you sleep.
Physical and speech therapy can help preserve or restore function.
If facial paralysis from Bell palsy lasts more than 6 to 12 months, surgery may be recommended to help the eye close and improve the look of the face. Surgery to relieve pressure on the nerve has not been shown to benefit most people with Bell palsy.
Most people with Bell palsy recover some or all facial function within a few weeks to six months. Sometimes the weakness lasts longer or is permanent.
When to see a doctor
Call 911 or go to the emergency room if your face weakness or drooping starts suddenly. Facial paralysis that comes on rapidly can be a stroke.
Call 911 or go to the emergency room if the facial weakness comes with a severe headache, a seizure, or blindness.
Call 911 or go to the emergency room if you also have sudden weakness in other parts of the body, an inability to speak, or a sudden change in mental state.
Contact your provider if you have weakness or numbness in your face that did not start suddenly. A provider can check for other, more serious conditions.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care doctor can do a first evaluation and arrange follow-up visits. They can also help coordinate care with specialists and therapists.
Common questions
Is facial paralysis always caused by a stroke?
No, a stroke is only one cause of facial paralysis. Bell palsy is the most common cause. If your face droops suddenly, call 911 so a stroke can be ruled out.
Does facial paralysis go away?
It depends on the cause. With Bell palsy, most cases go away completely within a few weeks to months. Sometimes taste changes, muscle spasms, or weakness remain.
Can facial paralysis harm the eye?
Yes. If the eye cannot close fully, it can dry out, which may lead to eye sores, infections, and vision loss. Eye drops, ointment, or an eye patch can protect it.
Can facial paralysis be prevented?
Not for Bell palsy, the most common cause, because there is no known way to prevent it.
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Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
