Facial Nerve Paralysis in Cats

Facial paralysis occurs when the nerve that sends information from the brain to the face is disrupted. Disruption can occur at the beginning of the nerve where it attaches inside the brain, resulting in weakness or paralysis of half or all of the face. It can also occur in any one of three of the branches that split off to deliver information to the eyelids and ears, the eyelids only, or the lips and nostrils.

The severity of facial paralysis depends on where in the nerve the disruption occurs, the underlying cause, and the level of damage to the nerve.

In cases where the nerve is affected on both sides of the brain, paralysis occurs on both sides of the face. This can be more difficult to recognize because facial symmetry is maintained.

If the disruption occurs in the brain, facial paralysis is sometimes accompanied by limb weakness, postural issues, lethargy, and lack of coordination (ataxia).

If the muscles around the eyes are affected, symptoms may include:

• Inability to blink
• Loss of reflexes in and around the eye
• Lower than usual ear position

Facial nerve paralysis around the eyes can lead to secondary eye conditions.

If the disruption occurs in the inner or middle ear, facial paralysis is sometimes accompanied by Head tilt and/or Horner’s syndrome, which is more commonly associated with ear, nose, and throat polyps .

Some cases of facial nerve paralysis affect the muscles around the mouth. Symptoms include:

• Hanging lips sometimes showing the gums
• Drooling
• Difficulty eating
• Difficulty drinking
• Difficulty clearing the mouth of food efficiently

In some cases, cats with paralyzed lips develop dermatitis (skin inflammation) at the lip fold due to accumulated saliva or other debris.

Facial paralysis is a rare disorder which is typically not life-threatening. Cats with asymmetrical facial expressions, difficulty blinking or eating, a tilted head, or changes to the eyes including sunken eyes, drooping eyelids, or pin-point pupils require prompt veterinary care. All genders and ages are equally susceptible.

The main symptom of facial paralysis is the inability to move all, half, or some parts of the face.

Cats with symptoms of facial paralysis require prompt veterinary attention to determine underlying causes.

Diagnostic tools include:

• Physical examination
• Ear examination
• Eye examination
• X-rays
• CT scan
• MRI
• Electromyography (testing the electrical activity to the muscles)
• Biopsy

Typically, cats require anesthesia to be examined.

Treatment depends on the underlying cause. Treatments may include:

• Thorough cleaning of the ears
• Antibiotics or antifungals
• Time to allow the paralysis to resolve on its own
• Surgical intervention
• Radiation therapy

Supportive care for facial nerve paralysis may include:

• Eye lubrication
• Soft diet to reduce need for chewing
• Cleaning of the skin around the eyes and mouth to prevent skin infections

In many cases, the causes of facial paralysis are not life-threatening. Some resolve in time. Some improve or change over time but never resolve completely. Some remain as they are at onset. The prognosis varies depending on the cause. In most cases, the prognosis is good. In cases where the nerve is damaged due to cancer, prognosis is more guarded.

There are no proven preventative measures for facial paralysis. Cats that are kept indoors and away from other animals are less likely to suffer bite wounds and car accidents. Cats that are a healthy weight are less likely to develop hyperlipidemia.

Facial paralysis is rare in cats.

• Medication
• Surgery
• Radiation
• Treatment of underlying condition
• Diet
• No treatment necessary