Congenital vs Acquired Facial Palsy

Congenital Facial Palsy: What Is It?

Congenital facial palsy (or congenital facial palsy syndrome) is a rare condition where the face develops abnormally from birth. It affects approximately 1 in every 100,000 births.

The exact cause of congenital facial palsy is unknown but it may be due to genetic or environmental factors. The condition causes paralysis of certain muscles in the face, which means the facial features on one or both sides of the face may be underdeveloped or absent.

Despite the facial paralysis, most people with this condition have no other health problems. Intelligence is not usually affected and most people with congenital facial palsy lead normal lives.

People with congenital facial palsy are at higher risk of infection due to the parts of the face not being able to move and allow the immune system to “flush” bacteria out. However, with good hygiene and medical attention this risk is reduced.

Acquired Facial Palsy: What Is It?

Acquired facial palsy, also called Bell’s Palsy, is caused by damage to the seventh cranial nerve. This nerve controls certain muscles in the face, which can become swollen and paralysed after an infection or other health issue. The condition can be temporary or permanent, depending on the cause.

Treatment for acquired facial paralysis includes administration of steroids, antiviral drugs, and antibiotics to reduce swelling in the nerve. If the condition is temporary, treatment will be to wait for the swelling to go down. In some cases, surgery can be used to cut the nerve and re-establish proper functioning.

However, most of the time there is little that can be done to re-establish facial movement.

What Are The Different Types Of Facial Palsy?

There are three main types of facial palsy, which are based on which specific part of the seventh cranial nerve is damaged. Each type affects a different area of the face, and in some cases can be accompanied by hearing loss.

Type I (Bell’s Palsy) affects the facial muscles on one side of the face. It can also cause the bit of skin between the nose and corner of the mouth to rise up slightly (a condition known as risus sardonicus). This type of facial palsy is caused by damage to the facial nerve on that particular side.

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It can be either temporary or permanent, and in some cases may even reoccur.

Type II (Horner’s Syndrome) affects the same area of the face as type I, in addition to one of the eyes. One eye will have a “blown pupil” which is a small slit rather than a circle. In some cases one eye will appear to be smaller than the other.

Type II is caused by damage to the sympathetic nervous system, which controls several important involuntary functions, including sweating and pupil size.

Type III affects the forehead, mostly between the eyebrows and above the nose. It can also cause the jawbone to shrink, causing a receding chin (a condition known as retrognathia). Type III is caused by damage to the parasympathetic nervous system.

What Are The Symptoms Of Facial Palsy?

One or more areas of the face do not move or have limited movement.

Trouble with eating or speaking.


Bulging eye.

Swelling around one side of the face.

How Is Facial Palsy Diagnosed?

A medical professional will take your medical history and give you a physical examination. You may undergo a MRI or other imaging tests to get a better idea of what is causing the facial paralysis.

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After taking all this information into account, your doctor should be able to tell you what’s causing your facial palsy and whether or not it can be treated.

What Treatments Are Available?

There is no guaranteed cure for facial palsy, but your doctor may be able to recommend a treatment plan to help alleviate the symptoms or minimize their severity. Treatment options may include:

Antiviral drugs.

Steroid injections to reduce the swelling in the nerve.

Surgery to cut the nerve and re-establish the connection between it and the face.

In extreme cases, a facial or “cranial” prosthetic may be used to restore physical appearance.

Speech therapy.

Occupational therapy to retrain the muscles in your face.


In most cases, facial palsy will go away within a year. Even if it doesn’t, most people do not experience long-term or serious side effects. Even after it goes away, your doctor may recommend physical therapy to retrain the muscles in your face to function properly.

When Should I Call A Professional?

Call your doctor immediately if you experience the following symptoms:

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Facial numbness that spreads to the ear or neck.

Difficulty swallowing.

Pain or difficulty moving the eye.

Weakness of the jaw or trouble chewing food.

Trouble hearing in one or both ears.

How Can I Prevent Facial Palsy?

The best way to prevent facial palsy is to avoid injury to the seventh cranial nerve. Symptoms of infection, inflammation, or tumors should also be brought to a doctor’s immediate attention. If you have a pre-existing condition that weakens the seventh cranial nerve, such as diabetes, you should be especially careful to avoid viruses and infectious diseases.

What Is The Long-Term Prognosis?

Most people will experience full recovery within a year, but complete recovery may take up to three years. In some cases, the mildest cases of facial palsy may not resolve at all. Facial re-education exercises may be able to minimize the effects of facial palsy.

Most people return to normal life after resolving the facial paralysis. Because of this, many people often forget that they ever had facial paralysis, although some people may experience depression and social anxiety during the time their facial palsy was at its worst.

When Should I Call A Mental Health Professional?

Most people with facial paralysis return to a relatively normal life. But, in some cases, depression and social anxiety can occur. If you or someone you know is experiencing social anxiety or feelings of depression, call your primary care physician immediately. They will be able to refer you to a mental health professional in your area.

When Should I Call The Emergency Services?

Call emergency services if you experience a “locked in” syndrome, where you are fully conscious but unable to move. This is a medical emergency and you will require immediate attention.

Do you know someone who suffers from facial palsy, or have you experienced this condition yourself?

We’d love to hear about your experiences in the comments section below.

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*Disclaimer: This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website!

Sources & references used in this article:

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