Sudden Facial Drooping After Injury: Possible Causes

Q: Sudden Facial Drooping After Injury: Possible Causes

Hello, Ms. <br>Juan：<br>Your symptoms are very similar to peripheral facial nerve palsy, primarily affecting the seventh cranial nerve. <br>The clinical symptoms include occasional numbness or stiffness in the face. <br>Due to the inability to close the eyelids, tearing may also

Waking up suddenly with a crooked mouth?

Hello Doctor: I have a history of hypertension.
Last Wednesday, I was hit on the left big toe by a piece of wood, which turned black and caused me intense pain that nearly made me faint.
That evening, I noticed some twitching on the left side of my face, and my left eye felt strange.
The next morning, I woke up to find that my philtrum was stiff, my mouth was crooked, and my eyebrows were uneven.
My toe has since healed.
I'm unsure what these symptoms indicate.
Could it be facial muscle spasms, facial nerve dysfunction, or something else? Thank you, Doctor.

Juan Jie, 60~69 year old female. Ask Date: 2021/06/03

Dr. Jiang Junyi reply Neurology

Hello, Ms.
Juan:
Your symptoms are very similar to peripheral facial nerve palsy, primarily affecting the seventh cranial nerve.
The clinical symptoms include occasional numbness or stiffness in the face.
Due to the inability to close the eyelids, tearing may also occur.
Sometimes, patients may notice an increased sensitivity to sound due to a decrease in the ear's acoustic reflex, as well as a reduced sense of taste on the tip of the tongue.
The impact on facial muscles is usually quite extensive.
In the acute phase of facial nerve palsy, symptoms may take some time to improve due to nerve damage.
The use of steroids in the first week is primarily to control inflammation and reduce the extent of nerve damage.
Aside from steroids, there is insufficient evidence to support the effectiveness of other treatment methods.
After the acute phase, there are almost no medications that are definitively helpful; however, vitamin B complex can be taken as an adjunct to other treatments, which may include vitamins, medications to improve blood circulation, as well as electrical stimulation, acupuncture, massage, low-level laser therapy, infrared irradiation, shortwave therapy, and facial muscle exercises.
P.S.
If you also experience unilateral limb weakness or double vision, it may be necessary to consider vascular diseases of the brainstem.
I recommend discussing your condition with a neurologist for evaluation and treatment, and to practice self-protection, cleanliness, and infection prevention measures before and after seeking medical care.
Thank you for your inquiry.
If you have further questions, feel free to discuss them! Wishing you good health and peace.
Dr.
Jiang Junyi, Taoyuan Medical Center, cares about you.

Reply Date: 2021/06/03

More Info

Sudden facial drooping after an injury can be concerning, especially when accompanied by symptoms such as facial asymmetry, stiffness, and abnormal eye movement. Based on your description, it seems you may be experiencing a form of facial nerve dysfunction, which could be due to several potential causes.

Firstly, the symptoms you describe—specifically the drooping of the mouth, uneven eyebrows, and stiffness in the midface—are indicative of facial nerve involvement. This could be a result of a condition known as Bell's palsy, which is characterized by sudden, unilateral facial weakness or paralysis. However, given your recent injury, it is also possible that the trauma could have led to a more acute form of facial nerve injury, particularly if there was any direct impact to the facial area or if there was swelling that could compress the nerve.

Another possibility is that you might be experiencing a transient ischemic attack (TIA) or even a mild stroke, especially considering your history of hypertension. Strokes can present with sudden facial drooping, and the fact that you have high blood pressure puts you at a higher risk for cerebrovascular events. It is crucial to rule out these serious conditions, as they require immediate medical intervention.

Facial muscle spasms or twitching, which you mentioned as "jumping," could also be a sign of facial nerve irritation or dysfunction. This could be due to the trauma you experienced, leading to inflammation or compression of the facial nerve. In some cases, the body may react to injury with spasms as a protective mechanism, but persistent or severe spasms should be evaluated by a healthcare professional.

Given the complexity of your symptoms and the potential for serious underlying conditions, it is essential to seek medical attention promptly. A neurologist or an ear, nose, and throat (ENT) specialist would be well-equipped to assess your condition. They may perform a physical examination, imaging studies such as a CT or MRI scan, and possibly nerve conduction studies to determine the extent of any nerve damage.

In the meantime, it is advisable to monitor your symptoms closely. If you experience any worsening of your condition, such as increased weakness, difficulty speaking, or any signs of stroke (like sudden numbness, confusion, or severe headache), seek emergency medical care immediately.

In terms of treatment, if it is determined that you have a facial nerve injury, management may include corticosteroids to reduce inflammation, physical therapy to help regain muscle strength, and possibly other medications to manage symptoms. Recovery can vary significantly depending on the cause and severity of the nerve involvement, but many individuals see improvement over weeks to months.

In conclusion, your symptoms warrant a thorough evaluation to determine the underlying cause and appropriate treatment. Given your history of hypertension and the recent injury, it is crucial to act quickly to ensure the best possible outcome. Please consult with a healthcare provider as soon as possible to address your concerns and receive the necessary care.

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