Characteristic is a paralytic course that is progressive beyond 3 weeks. A sudden onset, however, does not rule out the possibility of a neoplasm. The cause is unknown. Major factors affecting the eye are lagophthalmos, paralytic ectropion of the lower lid, concomitant trigeminal nerve loss, and decreased tear production. After paralysis, it is Long-term treatment for paralysis may include tarsorrhaphy, lateral canthoplasty, and gold weight implant to the upper lid.
Ophthalmologic consultation is indicated.
Priorities of rehabilitation are corneal protection, comfort, preservation of vision, improved function, and esthetic Restoration of function to the face is possible with several techniques. After a traumatic injury to the nerve, a microsurgical reanastomosis or nerve grafting is possible. Grafting donor sites include the sural, great auricular, and median antebrachial cutaneous nerves. For Bell's palsy, a wait of 12 months is advocated to monitor for spontaneous return of function before surgical intervention.