Treatment:

Treatment with antiviral medications, such as acyclovir or famciclovir, is recommended for 7 - 10 days, along with strong anti-inflammatory drugs called steroids (such as prednisone) for 3 - 5 days.

The steroids are tapered off in about 1 week. Sometimes strong painkillers are also needed if the pain continues even with steroids. While you have weakness of the face, wear an eye patch to prevent injury to the cornea (corneal abrasion) and damage to the eye if it does not close completely.

Expectations (prognosis):

The more severe the damage, the longer it will take to recover, and the lower the chance that you will completely regain normal function. If there is not much damage to the nerve, then you should get better completely within a few weeks. If damage is more severe, you may not fully recover-- even after several months.

Overall, chances of recovery are better if the treatment is started within 3 days of when the symptoms begin. If treatment is started at this time, 70% of patients make a full recovery.

However, when the treatment is delayed more than 3 days, the chances of complete recovery drop to about 50%. Children are more likely to have a complete recovery than adults.

Recovery may be complicated if the nerve grows back to the wrong areas (synkinesis), which may cause inappropriate responses, such as tears when laughing or chewing (crocodile tears). Some other people may experience blinking of the eye when they talk or chew food.

Complications:

Severe paralysis will lead to a poor recovery, possibly leaving you with permanent loss of movement in your face (facial paralysis) and uncontrolled movements (synkinesis).

If the eyelid doesn't close properly, damage to the cornea can occur. This can result in eye pain and blurred vision.

Occasionally, the virus may spread to other nerves, or even to the brain and spinal cord, causing:

• Back pain
• Confusion
• Drowsiness (lethargy)
• Headaches
• Limb weakness

This may require a hospital stay, where a spinal tap may help find out whether other areas of the nervous system have been infected.

Calling your health care provider:

Call your health care provider if you lose movement in your face, or you have a rash on your face that occurs with facial weakness.