Most people seek medical advice at once as they fear they may have had a stroke.
A short course of cortisone is often given to reduce the inflammation and nerve swelling. Most cases respond over weeks, or occasionally months, with no after-effects.
In about 3 per cent, complete paralysis persists. Partial paralysis remains in a little more than 5 per cent.
Several operations have been devised to overcome the deformity of persistent paralysis. The “static sling” uses a strip of fascia — thin connective tissue, usually overlying muscle — to thread through the facial muscles and hook them to the bones of, and above, the cheek.
This tries to create natural folds of expression around the mouth and to make both sides look the same. As its name implies, the result is static. There is no muscle movement when the other side moves.
A considerably more ambitious procedure is a nerve graft.
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