There are many, many things that can cause facial paralysis or facial weakness. The first and most concerning, especially in an older population is stroke. In a younger population, you’re worried about syndromes, you’re worried about other types of infections (congenital infections) that you can be born with. In the older population, you’re also worried about different types of viruses that can cause that problem. Ear infections that can cause that problem. Even a regular middle ear infection can cause that problem as part of the facial nerve runs around and in the middle year.