FACIAL PARALYSIS, a partial or total loss of power in the muscles of the face. One side of the face alone is usually affected. Paralysis may result from any disease of or injury to the facial nerve, either inside of the skull proper, or in its external distribution. Paralysis of the face very frequently occurs in apoplexies. Here the disease results from a disturbance of the nerve in its intracranial por tion. It also is occasioned by disease in the middle ear, but is most frequent following ex posure to cold, during which the external branches are involved. This latter form is termed Bell's palsy (q.v.). The symptoms of facial paralysis may vary according to the num ber of branches of the nerve that may be in volved. In a complete case the paralyzed side is flat and expressionless, the mouth is drawn toward the well side, making the well side look as though it were contorted and diseased. The patient is unable to whistle and may not be able to talk very clearly. The tongue may be
protruded toward the well side. There may be inability to close the eyelids. Sensation is not involved. When the patient eats he may not be able to move the tongue on the paralyzed side of the mouth and he cannot fill out his cheeks on the flat side. The electrical reactions of the muscles at first may not be affected, but later what is known as the reaction of degeneration sets in. Most cases of facial paralysis due to peripheral trouble, as well as Bell's palsy, re cover of themselves; others, due to hemiplegia or to inflammation of the middle ear or to fracture of the skull, recover less frequently.
Treatment is by means of tonics — iron, strychnine, arsenic and electrictiy. In intract able cases surgical anastomosis with other motor nerves may prove of service.