HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

question-icon

What Causes One-sided Facial Droop?

default
Posted on Thu, 8 Jan 2015
Question: Hello it's me again... I know I do not have a facial droop but the right side of my face looks as if it has aged more than my left side like everything has lowered a tiny bit. It can't be from ageing because I am only 20! I have attached a picture with arrows pointing towards where I feel it has sagged a little. Do you know what the reason is for this and can it be cured? Because It isn't Bell's palsy or anything. Also, I spoke about pain I was having before basically everytime I touch the trigmenial nerve in my face I can feel a sensitive nerve in my gum. Also my nerves in my gum and teeth hurt 24/7 from nerve pain. Will this go away??? If so when? Thank you.
doctor
Answered by Dr. Geldon Fejzo (3 hours later)
Brief Answer:
Gabapentin for nerve pain

Detailed Answer:
Hello again.

Everybody has some facial asymmetry. When I say everybody, I mean everybody. If you take a random face and divide it in the middle you will see those are not the same. This is not a problem, or something you should worry about. Now you have realised this difference, but if you will look carefully you will notice that this is the same for everyone else.

The pain instead can be troublesome. If it is not from the teeth and the EMG records no abnormal activity then it should go away. There is nothing to cause pain permanently. But it is difficult to say when this is going to go away. It might take weeks, also months as well. But if it is within normal limits it will definitely go away.

Meanwhile, Gabapentin might helpon the pain. Talk to your GP on the possibility of prescribing some Gabapentin to be taken at least for a month.

Hope this helps.

Sincerely, wish you the best help.


Above answer was peer-reviewed by : Dr. Raju A.T
doctor
default
Follow up: Dr. Geldon Fejzo (18 minutes later)
Thank you. I have realised I think the inflammation from the neuropathy is making my cheek look a little bit more bigger instead of me thinking it has sagged. What medication is the best to significantly reduce the inflammation? I have heard that prednisone is good to reduce it? When I touch my cheek it feels like water I just want the firm tight skin back.
doctor
Answered by Dr. Geldon Fejzo (12 hours later)
Brief Answer:
i do not recommend steroids

Detailed Answer:
Prednisone, which is a steroid, is a very strong anti inflammatory drug, with many adverse effects. I do not recommend using it, unless there is a strong indication. When I say strong I mean severe diseases, like autoimmune and tumors. Luckily yours seems a benign neuropathy, with little evidence of inflammation. If there is any sign of inflammation you can use simple ibuprofen for a few days, which is a good anti inflammatory drug, but with a few side effects, unlike prednisone which is very strong.

For the feeling of the face I recommend gabapentin or amitriptyline.

Best regards.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
default
Follow up: Dr. Geldon Fejzo (2 hours later)
Ok thanks. I'm very scared this isn't going to go away as I have read online that lots of people never get rid of it. And because of it I'm very conscious about my face because of the inflammation.

Also I have attached two images of my eye. One was before I noticed the slight saggyness and the other one was after I noticed it. The bottom eyelid used to be covering more of my eyeball and now it hardly does. I know it's only a tiny difference but I don't know why that has happened. Can physiotherapy make it go back to normal?
doctor
Answered by Dr. Geldon Fejzo (7 hours later)
Brief Answer:
Your face is already normal

Detailed Answer:
Hello. Physiotherapy in that region is done naturally by normal blinking. I do not notice a clear difference, meaning that most of normal people have that kind of difference. You face at the moment is perfectly normal, though not perfectly symmetrical, because nobody has a perfectly symmetrical face.

Again, your face is normal.

Sincerely.

Geldon Fejzo MD.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
default
Follow up: Dr. Geldon Fejzo (1 hour later)
Thanks. But it doesn't look the same as before I know it's only a tiny tiny different but why has it changed? Could it be from the neuropathy I'm experiencing in my face not allowing my muscles to stay XXXXXXX ?
doctor
Answered by Dr. Geldon Fejzo (7 hours later)
Brief Answer:
possible but not probable

Detailed Answer:
Hello. Your face looks normal. Of course, neuropathy can change the tonus of the muscles, but this does not seem your case. Wish the best health.
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
default
Follow up: Dr. Geldon Fejzo (2 hours later)
Does that even include eye muscles and nose muscles ?
doctor
Answered by Dr. Geldon Fejzo (2 hours later)
Brief Answer:
Not necessarily

Detailed Answer:
Hello.

If it is a facial palsy it would involve all facial muscles, including nose and eye muscles.

Still, your nose and eye muscles seem normal to me. But remember, they will never be the same with the muscles of the other part of the face. They never are.

Best regards.
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
default
Follow up: Dr. Geldon Fejzo (2 hours later)
But they have drooped a little bit which I don't find normal. Like the muscles move perfectly. Do u think I have just aged on one side of the face
doctor
Answered by Dr. Geldon Fejzo (1 hour later)
Brief Answer:
your face is ok

Detailed Answer:
I think your muscles are perfectly corresponding your age. In my opinion, since they move normally, leave behind this concern. There is nothing to worry. I would not worry. Suggest you do the same.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
default
Follow up: Dr. Geldon Fejzo (1 hour later)
Thank you. So this nerve pain in my face/teeth will definitely go away?
doctor
Answered by Dr. Geldon Fejzo (18 minutes later)
Brief Answer:
it will gi away.

Detailed Answer:
Definitely it will go away. No one can tell for sure when it will go away. It might take weeks, or maybe months. But for sure it will go away.

Sincerely.

Geldin Fejzo
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
default
Follow up: Dr. Geldon Fejzo (1 hour later)
What are the causes for facial neuropathy
doctor
Answered by Dr. Geldon Fejzo (29 minutes later)
Brief Answer:
many causes

Detailed Answer:

FORCEPS DELIVERY

Dystrophia myotonica

Möbius syndrome (facial diplegia associated with other cranial nerve deficits)

Trauma     Basal skull fractures

FACIAL INJURY

Penetrating injury to middle ear

Altitude paralysis (barotrauma)

Scuba diving (barotrauma)

Lightning

Neurologic     Opercular syndrome (cortical lesion in facial motor area)

Millard-Gubler syndrome (abducens palsy with contralateral hemiplegia caused by lesion in base of pons involving corticospinal tract)

INFECTION

     External otitis

Otitis media

Mastoiditis

Chickenpox

Herpes zoster cephalicus (Ramsay Hunt syndrome)

Encephalitis

Poliomyelitis (type 1)

Mumps

Mononucleosis

Leprosy

Influenza

Coxsackievirus

Malaria

Syphilis

Scleroma

Tuberculosis

Botulism

Acute hemorrhagic conjunctivitis (enterovirus 70)

Gnathostomiasis

Mucormycosis

Lyme disease

Cat scratch

Acquired immunodeficiency syndrome (AIDS)

METABOLIC

     Diabetes mellitus

Hyperthyroidism

Pregnancy

Hypertension

Acute porphyria

Vitamin A deficiency

NEOPLASTIC

     Benign lesions of parotid

Cholesteatoma

Seventh nerve tumor

Glomus jugulare tumor

Leukemia

Meningioma

Hemangioblastoma

Sarcoma

Carcinoma (invading or metastatic)

Anomalous sigmoid sinus

Carotid artery aneurysm

Hemangioma of tympanum

Hydradenoma (external canal)

Facial nerve tumor (cylindroma)

Schwannoma

Teratoma

Hand-Schüller-Christian disease

Fibrous dysplasia

Neurofibromatosis II

TOXIC

Thalidomide (Miehlke syndrome, cranial nerves VI and VII with congenital malformed external ears and deafness)

Ethylene glycol

Alcoholism

Arsenic intoxication

Tetanus

Diphtheria

Carbon monoxide

IATROGENIC

     Mandibular block anesthesia

Antitetanus serum

Vaccine treatment for rabies

Postimmunization

Parotid surgery

Mastoid surgery

Post-tonsillectomy and adenoidectomy

Iontophoresis (local anesthesia)

Embolization

Dental

IDIOPATHIC

     Familial Bell palsy

Melkersson-Rosenthal syndrome (recurrent alternating facial palsy, furrowed tongue, faciolabial edema)

Hereditary hypertrophic neuropathy

(Charcot-Marie-Tooth disease, Dejerine-Sottas disease)

AUTOIMMUNE

Amyloidosis

Temporal arteritis

Thrombotic thrombocytopenic purpura

Periarteritis nodosa

Landry-Guillain-Barré syndrome (ascending paralysis)

Multiple sclerosis

Myasthenia gravis

Sarcoidosis (Heerfordt syndrome, uveoparotid fever)

Osteopetrosis
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
default
Follow up: Dr. Geldon Fejzo (31 minutes later)
Mine happened after a night of heavy alcohol so do you think this is related to alcohol ?

My doctor said it's trigmenial neuropathy and I had it for 4 months
doctor
Answered by Dr. Geldon Fejzo (21 minutes later)
Brief Answer:
improbable

Detailed Answer:
One of the causes is alcohol intoxication, but in order for this to happen you should have alcohol for a long time.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
default
Follow up: Dr. Geldon Fejzo (1 minute later)
I've been drinking every weekend since I was 18 I am almost 21 now. Is that considered a long time?

Does this mean it is permanent ? (Sorry I am asking so many questions)
doctor
Answered by Dr. Geldon Fejzo (4 hours later)
Brief Answer:
it is not permanent.

Detailed Answer:
Hello. I doubt this being alcohol related. These situations tend to happen after you consume lots of alcohol for several years, like 20 or 30 years. I think you have a normal face. Try to enjoy it.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
Answered by
Dr.
Dr. Geldon Fejzo

Neurologist, Surgical

Practicing since :2009

Answered : 337 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

159 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
What Causes One-sided Facial Droop?

Brief Answer: Gabapentin for nerve pain Detailed Answer: Hello again. Everybody has some facial asymmetry. When I say everybody, I mean everybody. If you take a random face and divide it in the middle you will see those are not the same. This is not a problem, or something you should worry about. Now you have realised this difference, but if you will look carefully you will notice that this is the same for everyone else. The pain instead can be troublesome. If it is not from the teeth and the EMG records no abnormal activity then it should go away. There is nothing to cause pain permanently. But it is difficult to say when this is going to go away. It might take weeks, also months as well. But if it is within normal limits it will definitely go away. Meanwhile, Gabapentin might helpon the pain. Talk to your GP on the possibility of prescribing some Gabapentin to be taken at least for a month. Hope this helps. Sincerely, wish you the best help.