Damage to the Cranial Nerve 7 - Facial Nerve can happen as a result of:
About 90% to 98% of people with the health condition of Neurofibromatosis Type 2 (NF2), develop Vestibular Schwannoma (VS) on the Cranial Nerves for both sides of their head. These VS are sometimes also referred to as Acoustic Neuroma (AN). NF2 is not the only reason VS might grow.
When Schwannoma type tumors grow on the Vestibular Nerve, which affects balance, they are referred to as Vestibular Schwannoma. However, as these tumors grow they often damage surrounding nerves starting with the Cochlear Nerve and eventually the Facial Nerve but damage to potentially even more important nerves that could be fatal can be damaged if no treatment for the tumor is received. Treatment would be needed before those nerves are compromised.
If a tumor grows on some part of the face, or trauma to the face occurs, Facial Nerve function can be an issue, but depending on how far away from the point the nerve leaves the skull will determine what functions might be lost.
If damage to the face itself causes severe pain or numbness, damage to Cranial Nerve 5, the Trigeminal Nerve may also be an issue. Chances of natural healing or surgical reanimation offer a good chance of healing all or a higher percentage of the damage then when damage is done to the Facial Nerve when damaged inside the brain.
There are different treatment techniques for brain tumor removal; currently at least three for Vestibular Schwannoma removal with surgery, and different methods for of radiation treatments, but sometimes Facial Nerve damage, Facial Palsy, still occurs.
When a highly trained surgeon is found and allowed to help, the sooner treatment is given and the smaller a tumor or damage is, the better chances are of nerve preservation can take place.
Vestibular Schwannoma, are Schwannoma tumors along Cranial Nerve 8, are an issue that develops in many individuals with NF2. Cranial Nerve 8 travels a similar path as Cranial Nerve 7, the Facial Nerve, extending out of the brainstem right next to each other. The purpose of CN8 is hearing and balance. Individuals who develop Vestibular Schwannoma commonly develop damage to the Facial Nerve; also known as Facial Nerve damage, or Facial Paralysis.
Learn more about Hearing and Balance: CN8 - Vestibulocochlear Nerve.
The facial nerve branches off to smaller nerves and muscles that go to 5 different parts of the face. Therefore, when the nerve is damaged those smaller veins are not supplied with enough blood for circulation which is necessary for muscles on the different areas of the face to move. Each nerve branch affects the movement of different muscles.
The image to the right and the description shows how far the Facial Nerve reaches.
The nerves in the picture on the right show where on the face, outside of the skull, that the nerve branch extends out. The X in the image is pointing is the approximate location where the nerve extends outside of the skull, before branching to the different parts of the face.
Nerves that are a part of the Central Nerve System (CNS) do not heal as easily as nerves in other areas of the body. There are things that can be done to help the nerve heal that should be considered when a nerve might or has been damaged.
Natural healing that might take place will not visually be seen until about 4 to 6 months after the damage occurs. Everyone is different, so it might take more or less time for different people, but the majority of the healing that will occur on its own will be in the first year. The nerve damage will unlikely be completely restored on its own but there are some options to consider to help maximize the amount of healing.
A few things can help encourage the most amount of healing:
Non-surgical options when possible should be considered before surgical options, but if after time passes those do not do enough for you Facial Reanimation is an option you may want to consider.
Remember, all things should be taken in moderation.
Facial nerve physical therapy can consist of different types of treatments which should be discussed with a physical therapist.
3 forms of possibly physical therapy include:
Acupuncture helps to stimulate blood to flow back to the different nerves in the face to encourage movement. For maximum results, starting it within a few months after a nerve is damaged is ideal; each weekly treatment will help encourage the blood flow back into the face to help regain control little by little.
Vestibular Schwannoma (VS) surgery can result in damage to the facial nerve, but different techniques during surgery would make this less likely. Technique to remove these tumors and should be discussed with the surgeon.
If the nerve is damaged during surgical intervention to remove a Vestibular Schwannoma, the Facial Nerve, CN7, it might be possible to reattach the nerve to the Hypoglossal Nerve, CN12. This type of nerve graft can be done to try to regain blood flow to the nerve immediately after the nerve loses connectivity.
During surgery if the nerve is only damaged or some attempt to simply reconnect the nerve is done, some amount of healing will take place naturally with help from just physical therapy and time. It would be up to the patient to decide when or if additional surgical methods might be desired.
A Free Muscle Transplant is when a healthy "extra" muscle and transplanting it somewhere else in the body. The muscle can be used anywhere but needs to be attached somewhere with a working nerve.
Years after the facial nerve is damaged, you may want to consider Facial Reanimation surgery depending on how much has of the nerve has recovered or not. In this procedure the area the surgery happened is reopened from the ear down to the chin under the jaw bone. The nerve is reconnected to raise the droop in the face. There are different methods for this, talk to your doctors.
While there are Nerve and Muscle grafts and transplant options for moving most of the face, simple treatments are available for some of the Dry Eyes and Excessive Tearing issues that are caused by Facial Nerve Damage.
BOTOX® (OnabotulinumtoxinA) also known as Botulinum Toxin Type A is a Botulinum toxin produced by Clostridium Botulinum Bacteria.
Issue: Wrinkled Forehead Only on the side of No Paralysis
Facial Paralysis results in an inability to show expression on the side of the face an individual has Facial Paralysis. While looking for options for movement on the side with the facial paralysis, individuals may also be looking for limitations of movement on the other side, to prevent Forehead Wrinkling. BOTOX for paralysis patients is something insurance will cover and is something to consider, but it is also important to know risks. If the side effects listed develop, first response may need to be to discontinue the treatment before considering other health issues as the cause. Talk to your doctor.
"When a small amount of Botox is injected into a muscle, it blocks nerve signals that tell your muscles to contract. The effect is that it temporarily weakens or paralyzes the facial muscles and smooths or eliminates wrinkles in the skin for a few months." [WebMD, BOTOX]
"Very serious problems can happen if the botulinum toxin spreads from where it was injected. It may cause dangerous issues like; swallowing or breathing problems. These problems can happen hours to weeks after the injection and can cause death. The risk is greatest in children who are being treated for muscle spasticity in their necks. But adults who already have swallowing or breathing problems are also at risk for problems from a Botox injection." [WebMD, BOTOX]
"The risks of repeated Botox injections are not known." [WebMD, BOTOX]
Other reasons for possible swallowing issue include tumor growth on the; lower branch of Trigeminal Nerve (Cranial Nerve 5 the Mandibular branch), or 2) Vagus Nerve (Cranial Nerve 10). A tumor on the Vagus Nerve could also result in breathing issues.
There is a one-percent (1%) risk of illness from Botulinum infection for people taking CAPE Propolis.
Tumors that grow on the nerves that affect hearing and balance tend to push on the Facial Nerve which follows a similar path inside the brain. During different tumor management techniques used to preserve hearing and balance the Facial Nerve is lost.
Focused Radiation treatments can damage nerves in the surrounding area, but different Microsurgery surgery techniques to remove VS are less likely to damage the Facial Nerve. However, if the tumor is already affecting the Facial Nerve, the chance of saving the nerve regardless of treatment choice would be minimal.
Facial Nerve damage can also cause Diplopia (Double Vision or Lazy Eye), as well as Nystagmus and Oscillopsia. Learn about NF2 Eye Issues.
The Facial nerve does not control all of the functions of the face and are controlled by Cranial Nerve 5, the Trigeminal Nerve which includes the following 3 branches:
No. Pain or any other feeling, numbness or lack of feeling in the face is the result of damage of Cranial Nerve 5 (CN5), the Trigeminal Nerve.