Medical conditions that affect the face

Because the face is composed of many structures, including nerves, muscles, sinus cavities, and bones, it is susceptible to unique disease processes. Here are the medical conditions that often cause facial symptoms.

1) Bell’s palsy

Bell’s Palsy is named after Sir Charles Bell, a 19th-century Scottish neurologist who was the first to describe the condition. Bell’s Palsy occurs when the seventh cranial nerve, which controls the facial muscles, becomes inflamed. This inflammation causes paralysis of the muscles along one side of the face.

Patients with Bell’s Palsy experience sudden onset of a one-sided facial droop, an uneven smile, and the inability to close their eyes.

In most cases, the paralysis is temporary and resolves in a matter of weeks or months. In rare cases, the paralysis is permanent.

Bell’s Palsy most often occurs in patients between the ages of 16-60. Other risk factors include pregnancy, diabetes, or a family history of the condition.

2) Trigeminal neuralgia

Trigeminal Neuralgia (TN) is a chronic pain condition caused by inflammation or compression of the trigeminal nerve, which carries pain signals from the face to the brain.

Patients with TN experience sudden, severe, searing pain along their forehead, cheek, or jaw. Sometimes even gentle stimulation triggers the pain, and patients find it difficult to brush their teeth or apply makeup.

Sometimes TN occurs as the result of facial trauma or dental procedures. In other cases, it can be caused by a brain tumor that’s compressing the trigeminal nerve. TN can also be a symptom of multiple sclerosis. In most cases, however, TN is idiopathic, meaning there is no known underlying cause.

For reasons not yet well understood, women are twice as likely to develop TN than their male counterparts. The most common treatment for TN is an oral anticonvulsant medication that makes the pain-sensing neurons less excitable.

3) Sinusitis

Sinusitis occurs when the lining of the sinuses becomes infected or inflamed. In more than 90 percent of cases, sinusitis is caused by a viral infection. In rare cases, sinusitis can be caused by a bacterial or fungal infection.

Patients with sinusitis often experience nasal and sinus congestion, headaches, and facial pressure. In more serious cases, they can also experience facial pain, fevers, and facial swelling.

4) Stroke

A stroke (in medical terms, a cerebrovascular accident, or CVA), is caused when blood flow within the brain is obstructed.

There are two main types of strokes: ischemic and hemorrhagic. An ischemic stroke occurs when a blood vessel is blocked by a clot, or by atherosclerosis, a condition that causes arteries to narrow as a person ages. A hemorrhagic stroke occurs when a blood vessel ruptures and causes bleeding inside the brain.

The symptoms of a stroke vary depending on how severe the stroke is, and which part of the brain it affects. Stroke symptoms can include slurred speech, weakness in an arm or a leg, dizziness, confusion, or balance problems. Strokes can also cause a one-sided facial droop.

Since both Bell’s Palsy and strokes can cause one-sided facial paralysis, it’s important to note two key differences between these two conditions.

First, Bell’s Palsy affects the muscles of the forehead, but strokes do not, because Bell’s Palsy affects superficial nerves, but strokes affect nerves deeper inside the brain.

And second, Bell’s Palsy only causes facial paralysis, whereas strokes often cause other neurologic symptoms.

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Sources:

https://www.mayoclinic.org/diseases-conditions/bells-palsy/symptoms-causes/syc-20370028

https://www.mayoclinic.org/diseases-conditions/trigeminal-neuralgia/symptoms-causes/syc-20353344

https://medlineplus.gov/ency/article/000647.htm

https://www.mayoclinic.org/diseases-conditions/ramsay-hunt-syndrome/symptoms-causes/syc-20351783

https://www.cdc.gov/stroke/signs_symptoms.htm

Written by Sarah Thebarge, Physician Assistant