Facial Paralysis
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Try one of these related symptoms.
One eye won't close completely
Unable to wrinkle one half of my forehead
Facial nerve paralysis
Can only wink with my left eye
Unable to lift one side of my forehead
Less muscle control on one side of face
My mouth is distorted
Unable to close my left eye
Can't lift one eyebrow
Bell's palsy
Can't blink right eye
Can't raise corner of the mouth
About the Symptom
Facial paralysis occurs when a person is cannot move some or all of the muscles on one (or both sides) of the face.
When to See a Doctor
Seek professional care if you experience any of the following symptoms
- Can't move face
Possible Causes
Generally, Facial paralysis can be related to:
- Cheilitis Granulomatosa (Granulomatous Cheilitis)
Cheilitis granulomatosa is a rare condition, characterized by painless but persistent inflammatory swelling of the lip. The cause is unknown, but could be due to factors like foreign body reactions, infections, and other inflammatory conditions.
- Porphyria
Porphyrias are a group of inherited or acquired disorders caused by a buildup of natural chemicals that produce porphyrin in the body. Porphyrins are necessary for hemoglobin function. Common triggers include drugs (birth control pills, sedatives, etc.), fasting, smoking, drinking alcohol, infections, emotional and physical stress, hormonal imbalance, and sun exposure.
- Tolosa Hunt Syndrome
Tolosa-Hunt Syndrome is a rare condition characterized by severe headaches behind the eyes, decreased and painful eye movements typically in just one eye. The exact cause is unknown, but it may be related to inflammation in certain areas behind the eye.
- Amyotrophic Lateral Sclerosis (ALS)
Related Serious Diseases
Sometimes, Facial paralysis may be related to these serious diseases:
- Bell's Palsy
Characterized by sudden weakness or paralysis of the facial muscles, Bell's palsy is usually temporary and occurs on one side of the face. The exact cause is unknown but is believed to be due to swelling and inflammation of the nerve controlling the facial muscles or viral infection. Anyone can be affected by this condition, but pregnant women, those with lung infections, and those with a family history of the condition are at higher risk.
- Vertebral Artery Dissection
- Guillain-Barre Syndrome (GBS)
- Encephalitis / Encephalopathy
- Cerebellar Hemorrhage / Infarction
- Transient Ischemic Attack (TIA)
Doctor's Diagnostic Questions
Your doctor may ask these questions to check for this symptom:
- Do you have difficulty moving your facial muscles?
- Which of the following best describes how your difficulty moving facial muscles appeared?
- Is it hard to raise one corner of your mouth when you smile?
- Is it hard for you to frown on one side?
- Are you unable to blink one eye?
Reviewed By:
Benjamin Kummer, MD (Neurology)
Dr Kummer is Assistant Professor of Neurology at the Icahn School of Medicine at Mount Sinai (ISMMS), with joint appointment in Digital and Technology Partners (DTP) at the Mount Sinai Health System (MSHS) as Director of Clinical Informatics in Neurology. As a triple-board certified practicing stroke neurologist and informaticist, he has successfully improved clinical operations at the point of care by acting as a central liaison between clinical neurology faculty and DTP teams to implement targeted EHR configuration changes and workflows, as well as providing subject matter expertise on health information technology projects across MSHS. | Dr Kummer also has several years’ experience building and implementing several informatics tools, presenting scientific posters, and generating a body of peer-reviewed work in “clinical neuro-informatics” – i.e., the intersection of clinical neurology, digital health, and informatics – much of which is centered on digital/tele-health, artificial intelligence, and machine learning. He has spearheaded the Clinical Neuro-Informatics Center in the Department of Neurology at ISMMS, a new research institute that seeks to establish the field of clinical neuro-informatics and disseminate knowledge to the neurological community on the effects and benefits of clinical informatics tools at the point of care.
Shohei Harase, MD (Neurology)
Dr. Harase spent his junior and senior high school years in Finland and the U.S. After graduating from the University of Washington (Bachelor of Science, Molecular and Cellular Biology), he worked for Apple Japan Inc. before entering the University of the Ryukyus School of Medicine. He completed his residency at Okinawa Prefectural Chubu Hospital, where he received the Best Resident Award in 2016 and 2017. In 2021, he joined the Department of Cerebrovascular Medicine at the National Cerebral and Cardiovascular Center, specializing in hyperacute stroke.
Content updated on Feb 10, 2025
Following the Medical Content Editorial Policy
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People with similar symptoms also use Ubie's symptom checker to find possible causes
- Raising the corner of the mouth is not possible
- Can only wink with my right eye
- My face is stiff and doesn't move
- Corner of the mouth does not rise
- Facial muscles do not move well
- Facial muscles do not move
- I can't blink on one side only
- Hard to move your mouth
- No power between eyebrows
- Difficult to move eyelids
- Unable to close my right eye
See full list
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FAQs
Q.
Severe Facial Damage? Why Your Face Is Restorable + Medically Approved Next Steps
A.
Most severe facial injuries are restorable, with modern reconstructive options like microsurgery, free tissue transfer, nerve repair, advanced 3D planning, and in rare cases a face transplant, with function restored first and appearance improved next. Medically approved next steps include urgent evaluation for red flags, referral to the right specialists, targeted imaging and testing, staged reconstruction, and mental health support. There are several factors that can change your best next step, so see the complete guidance below for specific emergencies to act on now, which specialists to see, and the tests and treatments to consider.
References:
* Patel N, Al Khalili Y. Facial Trauma: An Overview of Assessment and Management. 2022 Aug 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 35948926.
* Fan R, Guo S, Zhang C, Zhang C, Chen G, Wang Y. Advances in maxillofacial reconstruction. Mil Med Res. 2020 Nov 2;7(1):54. doi: 10.1186/s40779-020-00282-1. PMID: 33139886; PMCID: PMC7605912.
* Ziebart J, Abumuaileq D, Al-Naji M, Singh-Saluja M, Al-Sabri M, Jabbour Z, Alolabi B, El-Bialy T. Tissue Engineering and Regenerative Medicine in Craniomaxillofacial Surgery: A Scoping Review. J Funct Biomater. 2023 Aug 24;14(9):437. doi: 10.3390/jfb14090437. PMID: 37628045; PMCID: PMC10534289.
* Selim A, Badawi M, Hassan M, Elsabaa I, Awad E, Ibrahim A, Ahmed AA. Facial Allotransplantation: Current Status and Future Directions. J Clin Med. 2023 Mar 30;12(7):2690. doi: 10.3390/jcm12072690. PMID: 37021235; PMCID: PMC10094943.
* Chang C, Haughey C, Sannino A, Patel S, Khoynezhad T, Patel K, Samaan J. Current Concepts in Complex Maxillofacial Reconstruction. J Craniofac Surg. 2022 Nov-Dec 01;33(8):2190-2195. doi: 10.1097/SCS.0000000000008892. PMID: 36365318.
Q.
Lip Flip Fail? Why Your Lip Is Drooping & Medically Approved Next Steps
A.
Lip flip drooping can happen when botulinum toxin spreads, the dose is too high, or placement is off; it is usually temporary, peaking around days 10 to 14 and improving over 6 to 8 weeks. Medically approved next steps are to contact your injector, be patient if symptoms are mild while protecting lip function, and seek urgent care for sudden or widespread facial drooping, slurred speech, weakness, or vision changes; there are several factors to consider, and key details that may change your plan are explained below.
References:
* De Almeida, V. R., Cazarini, A., De Castro, B. V., Neves, M., & De Almeida, B. R. (2019). Complications of botulinum toxin type A in the perioral region. *Journal of Cosmetic Dermatology, 18*(2), 522-527.
* Lee, J. I., & Kim, Y. J. (2021). Management of Botulinum Toxin Complications. *Seminars in Cutaneous Medicine and Surgery, 40*(2), 159-169.
* Liguori, A., D'Amico, M., Capasso, L., Grimaldi, R., Cacciapuoti, C., & Ruggiero, C. (2022). Adverse Events of Botulinum Toxin Injections in the Lower Face and Neck: A Systematic Review. *Toxins, 14*(7), 466.
* Sundaram, H., Liew, S., Signorini, M., Braz, A. V., Fagien, S., Goodman, G. J., ... & Rzany, B. (2020). Complications and Adverse Events of Botulinum Toxin A Injections for Facial Aesthetics: A Review. *Aesthetic Plastic Surgery, 44*(6), 1986-2003.
* Kang, W., & Lee, H. J. (2023). Anatomical Considerations for Safe Botulinum Toxin Injections in the Perioral Region. *Toxins, 15*(4), 282.
Q.
Sudden Facial Droop? Why Your Face Is Frozen & Medically Approved Next Steps
A.
Sudden one-sided facial droop is most often Bell’s palsy, but stroke must be ruled out immediately; forehead involvement and isolated facial weakness favor Bell’s palsy, while any arm or leg weakness, slurred speech, confusion, vision changes, severe headache, or balance problems point to stroke and require calling emergency services. Medically approved next steps include urgent evaluation within 72 hours for possible corticosteroids, eye protection if the eye will not close, and checking for other causes like Ramsay Hunt or Lyme. Most people with Bell’s palsy improve within weeks to months, but there are several factors that can change your next steps, so see the complete guidance below.
References:
* Tadi P, et al. Facial Palsy: Differential Diagnosis and Treatment. StatPearls Publishing; 2023 Jan-. PMID: 32644445.
* Linder TE, et al. Bell's Palsy: Current Treatment and Future Perspectives. Laryngoscope. 2020 Jun;130(6):E316-E322. doi: 10.1002/lary.28315. Epub 2019 Sep 3. PMID: 31482594.
* Powers WJ, et al. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update From the American Heart Association/American Stroke Association. Stroke. 2019 Mar;50(3):e344-e418. doi: 10.1161/STR.0000000000000211. Epub 2019 Jan 24. PMID: 30711378.
* Kim YH, et al. Ramsay Hunt Syndrome. StatPearls Publishing; 2023 Jan-. PMID: 30137748.
* Söderman AC, et al. Bell's palsy and other facial nerve disorders: evidence and expertise-based guideline for diagnosis and therapy. Acta Otolaryngol. 2018 Jun;138(6):592-598. doi: 10.1080/00016489.2018.1432240. Epub 2018 Mar 6. PMID: 29509376.
Q.
Face Droops When I Laugh: Is It Serious? Causes for Women 65+
A.
There are several factors to consider: in women 65+, facial drooping when laughing can result from normal age related muscle and skin changes or dental and TMJ issues, but it can also signal Bell’s palsy, a prior silent stroke, a mini stroke, or rarely facial nerve compression. Sudden onset or droop with slurred speech, limb weakness, vision changes, or a severe headache is an emergency, while gradual, stable changes are often less urgent but should still be discussed with a doctor. For key red flags, what to do next, and ways to reduce risk, see the complete details below.
References:
* Salomone, N., Del Negro, C., Vitrani, G., Bracci, F., De Vito, A., Scarascia, A., ... & Capuano, C. (2023). Facial nerve disorders in older adults: An updated review. *The Journals of Gerontology: Series A*, *78*(6), 947-957. doi: 10.1093/gerona/gmad033. PMID: 36946950.
* Paciaroni, M., Caso, V., Venti, M., Milia, P., Tsiskaridze, A., & Agnelli, G. (2009). Sex differences in stroke symptoms and time to hospital arrival: results from the acute stroke registry and analysis of Lausanne (ASTRAL) study. *Stroke*, *40*(3), 792-797. doi: 10.1161/STROKEAHA.108.529803. PMID: 19164786.
* Kim, J. S., Lee, M. S., & Kim, Y. H. (2008). Clinical features and prognosis of Bell's palsy in elderly patients. *Journal of Clinical Neurology*, *4*(3), 118-121. doi: 10.3988/jcn.2008.4.3.118. PMID: 19125211.
* Tan, Z., Xia, L., Li, G., Xie, R., & Yu, S. (2012). Clinical characteristics of hemifacial spasm in the elderly. *Journal of Craniofacial Surgery*, *23*(2), 503-506. doi: 10.1097/SCS.0b013e31824d57c5. PMID: 22446736.
* Johnston, S. C., Gress, D. R., & Vozick, E. (2005). Transient ischemic attack in women: a comparison with men. *Stroke*, *36*(9), 1825-1829. doi: 10.1161/01.STR.0000177708.20456.ee. PMID: 16109919.
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