Paralysis in the face can be both uncomfortable and also emotionally difficult. With facial paralysis a person may have varying degrees of muscle weakness in the face, loss of sensation, and drooping and distortion. It can cause physical pain but this condition is also embarrassing and can have a big impact on mental and social well-being.
Babies may suffer paralysis because of nerve damage during deliver, and this is often temporary. Adults may develop facial paralysis from infections or surgical errors. Any of these cases may be treatable or temporary, but they can also be permanent and severe. If you or your child is suffering from facial paralysis and you believe a doctor may be to blame for it, you could have a valid medical malpractice case.
What is Facial Paralysis?
Facial paralysis is loss of sensation, muscle weakness, and loss of control of muscles in the face, often in just one side. It usually results from nerve damage, and it may range from mild and barely noticeable to severe and complete inability to move the muscles. Some forms of this are called Bell’s palsy and may occur when nerves that control facial muscles get compressed or are inflamed or swollen.
The seventh cranial nerve controls muscles in the face and runs through a canal in the skull, under the ears, and attaches to muscles at each side of the face. The nerve is responsible for controlling things like blinking of the eyes, facial expressions, and the production of the tear and saliva glands. It also gives sensation to various parts of the face.
Symptoms of Facial Paralysis
When facial nerves are damaged in some way, the messages to and from the brain and face are disrupted. Because the nerves control so many facial muscles, the symptoms can be different from one person to the next. There may be varying degrees of loss of sensation and loss of control over muscle movement.
A person with facial paralysis may have muscle twitches, muscle weakness, drooping eyelids or lips, dry eye or mouth, drooling, lack of taste, and excessive tearing in the eyes. To onlookers the face may appear distorted. Facial paralysis can also cause pain, headache, sensitive to sound, ringing in the ears, dizziness, and difficult speaking, eating, and drinking. Symptoms may be in one side of the face or both. With Bell’s palsy the paralysis occurs on just one side.
Facial Paralysis at Birth
Anyone at any age can suffer from facial paralysis from a range of causes, but one particular type of paralysis is the result of birth injuries. The seventh cranial nerve can be damaged during delivery, causing facial paralysis. Although there could be many causes, in many cases some complication of delivery causes the nerve to be compressed.
In an infant, facial paralysis may show specific signs, such as one eyelid not closing. The nerve damage may also cause the face to look uneven, especially when the baby is crying. It can also lead to limited movement of the mouth. In severe cases a baby may not be able to move its face very much or even at all. For some babies the paralysis will go away as the nerve heals, but in more severe cases of damage, surgery may be required and the paralysis may be permanent.
Factors that can lead to damage of the facial nerve during childbirth include an unusually high birth weight, a prolonged or complicated pregnancy or labor, epidural anesthesia, or the use of other medications that are intended to trigger labor and stronger contractions. Excessive force during delivery, especially with instruments like forceps, may also damage the facial nerve by compressing it.
Other Causes of Facial Paralysis
Facial paralysis that occurs outside of labor and delivery may result from a variety of causes. Infections, for instance, are thought to be the leading cause of Bell’s palsy: herpes, chickenpox and shingles, respiratory viruses, German measles, mumps, the flu, hand-foot-and-mouth disease, mononucleosis, and cytomegaloviruses have all been implicated.
Damage to the seventh cranial nerve may also result from surgical errors. Cosmetic and otologic (ear) surgeries are most often cited as causing facial paralysis. Other surgeries that may lead to nerve damage and facial paralysis include salivary gland surgery and head and neck surgery.
Consequences of Facial Paralysis
Many instances of facial paralysis, including birth-related paralysis and infection-caused Bell’s palsy, are temporary. The nerves often heal over time and function is restored to the muscles in the face. However, some people suffer lasting damage and sometimes severe paralysis. This can cause pain and dysfunction in the eyes and with eating or speaking. It can cause chronic pain and the need for additional surgeries and treatments, along with expensive medical bills. There is also likely to be emotional suffering and even painful social isolation from the embarrassment of having facial paralysis.
Facial Paralysis Malpractice
In some cases facial paralysis is truly accidental and there may be nothing that a medical professional could have done to prevent it. But in other cases there is blame to place and different actions by a doctor could have prevented this terrible condition. Malpractice during labor and deliver, for instance, may include excessive use of force or inappropriate use of forceps, failure to detect and manage complications like high birth weight, or excessive use of medications or anesthesia.
For an adult with Bell’s palsy, an infection that was not diagnosed accurately or in time for good treatment could be the cause and could be the result of medical negligence. Surgical errors that cause damage to the facial nerve can also often be considered negligence. A study of malpractice cases involving facial paralysis and surgery found that the most often-cited accusation was surgical misadventure, followed by lack of informed consent and failure to diagnose. Most cases cited more than one allegation.
A Facial Paralysis Medical Malpractice Case
Cases of medical malpractice involving facial paralysis sometimes end in settlements or jury awards to the plaintiffs. In one such case a woman received a settlement of $1.7 million after having surgery to help improve her ability to hear. She was having an older ear implant removed and replaced, and she woke up from the surgery with difficulty speaking and drooping facial muscles.
While the paralysis has not disabled the woman it has been determined to be permanent. She has had to pay extensive medical bills for treatment and will have to live with a drooping face and some difficulties with eating and speaking. The legal team for the woman was able to make the case that the cause of paralysis was damage to the facial nerve during surgery.
Facial paralysis is not always a debilitating condition, but it is a serious problem for many who struggle with it. They face pain and complications with speaking and eating; they may have to have additional surgeries; and perhaps most troubling, they have to live with a distorted face. If you have suffered facial paralysis, talk to a medical malpractice lawyer to find out if you have a case that could be successful.
Sources
- https://medlineplus.gov/ency/article/001425.htm
- https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Bells-Palsy-Fact-Sheet
- https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/483692
- http://molawyersmedia.com/momedlaw/2016/03/29/woman-settles-with-surgeon-over-facial-nerve-injury/