Facial Palsy Awareness Week Quiz

Correct! Many people associate facial palsy with a stroke and have not heard of the other causes, this is why more awareness is urgently needed.

Correct! There are more than 50 different causes of facial palsy, these include viral, various syndromes and tumours, trauma, infections, vascular and neurological problems, and more.

Correct! Bell’s palsy is the most common cause, it affects two in sixty adults during their lifetime. It is called Bell’s palsy when the paralysis comes on suddenly and no other cause is identified.

Correct! The normal treatment for Bell's palsy in the UK is to give oral steroids within 72 hours of onset of symptoms unless other health conditions preclude their use.

Correct! The combination of the shingles virus causing facial palsy is called Ramsay Hunt syndrome.

Correct! Both antivirals and steroids should be given within 72 hours unless other health conditions preclude their use. Antiviral medication will treat the virus and steroids will help reduce inflammation.

Correct! Ramsay Hunt syndrome is typically extremely painful with a rash in or around the ear, or blisters in the mouth. It is caused by the same virus that causes chickenpox (varicella zoster virus). A small number of people may not have a rash.

Correct! Women in the last trimester of pregnancy are at a higher risk of developing Bell’s palsy than the general population.

Correct! Lyme disease is a bacterial infection that is spread to humans by infected ticks. Ticks are tiny arachnids and commonly found in heath and woodland areas. Some people develop facial palsy when they have Lyme disease but not everyone with Lyme will have facial palsy.

Correct! If the sixth cranial nerve (the abducens nerve) is affected, the eye(s) cannot turn outwards, i.e. away from the nose. Moebius syndrome is a complex and rare congenital condition with many other additional signs and symptoms often present. The seventh cranial nerve controls eye closure and the smile.

Correct! Synkinesis (pronounced sink-eye-nee-sis) means the development of linked or unwanted facial movements. It is common and occurs in the majority of people who are recovering from prolonged facial palsy. One example of synkinesis is where the eye closes every time the person smiles.

Correct! There are 21 different physical issues that can be associated with facial palsy yet it is often dismissed as a cosmetic condition.

Correct! According to our 2019 survey of 211 people who requested follow-up health care from their GP, 42% were told that the GP didn’t know where to send them for further help. Answers a and c were also reasons given for not being referred.

Correct! In someone with facial palsy, if the eye is watering profusely this is often a sign the eye is too dry. The eye over-waters to compensate for the dryness. The patient should seek advice from an ophthalmologist. The eye may also water due to abberent reinnervation, commonly known as crocodile tears. This may be triggered, for example, when the patient eats and their eye waters.

Correct! Melkersson-Rosenthal syndrome is a rare neurological disorder characterised by recurring facial paralysis or palsy, swelling of the face and lips (usually the upper lip), and the development of folds and furrows in the tongue. Patients don’t always display all of these symptoms.

Correct! A vestibular schwannoma is commonly known as an acoustic neuroma albeit that is not technically correct. (The term acoustic neuroma has been replaced by the more accurate term vestibular schwannoma, but both remain in use).

Correct! Medication is often the first line treatment for pain but a combination of specialist facial therapy and Botulinum toxin injections (e.g. Botox) can help relieve muscle tightness and pain.

Correct! Facial palsy is often mistakenly thought to be a cosmetic issue rather than a health condition that affects facial function.

Correct! Sylvester Stallone had a difficult entry into the world in 1946. Forceps used during his birth caused paralysis in parts of his face affecting parts of his lip, chin and tongue. After years as a struggling actor and playwright in New York, he went on to write Rocky. He was first offered $360,000 for the script - providing he agreed to not star in it. Instead, he took a paltry salary plus a cut of the profits in order to star in it and the rest is history.

Correct! Specialist Facial Therapy is a post-graduate specialism that is not currently taught as part of a physiotherapy degree. The facial muscles are different to muscles elsewhere in the body and are affected by emotions as well as normal pathways. General physiotherapy elsewhere in the body tends to involve large movements with a focus on strength whereas specialist facial therapy focuses on precise, coordinated movement re-education to aid recovery.