Medical therapy for acute facial paralysis consists of oral steroid therapy as well as oral antiviral therapy. The treatment window for acute facial paralysis is narrow and it is best to start steroid and antiviral therapy as soon as possible after symptom onset.
For chronic facial paralysis with synkinesis, botulinum toxin (Botox) therapy is used to selectively weaken hyperfunctional facial musculature. The judicious use of Botox can help restore symmetry to the face as well as provide relief from facial spasms and contractures. The treatment effects of Botox last between 3 – 6 months.