Facial nerve palsy is treated in two ways: firstly, we treat the underlying disease, for example diabetes or Lyme disease, if this is the cause. Correct adjustment of blood sugar or treatment of Lyme disease with antibiotics can already improve facial paralysis. If your facial nerve has been severed due to a skull injury, for example, we can reconnect the nerve endings in an operation. In the case of long-standing damage to the facial nerve, e.g. after tumor removal, motor replacement procedures can be used by transplanting muscles or nerves. Secondly, we treat the direct effects of the symptoms of paralysis.
In the case of idiopathic facial nerve palsy, which has no identifiable cause, treatment is aimed only at the symptoms.
Most treatments for facial nerve palsy can be carried out on an outpatient basis. An inpatient stay may be necessary if the facial paralysis is bilateral, if complications occur or if other cranial nerves are involved.
Cortisone against nerve damage
High doses of cortisone have a positive effect if they are administered up to 48 hours after the onset of facial nerve palsy. The effect is presumably due to the decongestant effect of the cortisone, which limits the damage to the nerve.
Keep the eye moist
Drops with artificial tears or ointments protect the eye that you can no longer close from drying out. A bandage may be necessary at night to keep it moist. Without these measures, there is a risk of a corneal ulcer forming.
If the eyelid closure disorder does not improve, it may help to reduce the palpebral fissure surgically. Or you can have the upper eyelid weighted so that it closes. Initially, lead weights may be temporarily attached externally, and then under certain circumstances, gold or platinum weights may be permanently implanted under the skin.
Botulinum toxin against disruptive muscle movements
If individual facial muscles move involuntarily, for example if your eyelid closes when you speak, botulinum toxin can help: If it is injected into the corresponding muscle, it can prevent disruptive muscle movements.
Surgical procedures for facial expressions
If the facial paralysis is permanent and affects you or disfigures you, there are a number of options for reconstructive surgery. To help you regain your facial expressions, it is possible, for example, to transplant parts of the chewing muscles or parts of the thigh into the cheek.