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Bell’s Palsy

Published on Jan 25, 2019   -  5 min read

Abstract

Abstract

Bell’s palsy, also known as facial palsy, is a condition that causes sudden and temporary weakness or paralysis of the facial muscles, which results in an inability to control the muscles on the affected side of the face.

Bell’s Palsy
Contents

What Is Bell’s Palsy?

Bell’s palsy, also known as facial palsy, is a condition that causes sudden and temporary weakness or paralysis of the facial muscles, which results in an inability to control the muscles on the affected side of the face. The affected side of the face droops or becomes stiff. The affected person’s smile is one-sided, and the eyelids on that side resist closing.

The exact cause is still unknown, but it is said to be caused due to some injury or swelling or inflammation of the 7th cranial nerve (facial nerve). Sometimes, it occurs as a result of some reaction to a viral infection. It can happen to anyone at any age, and most of the time, it is temporary. There is no gender or racial preference. It can occur at any age, but more cases are seen in mid and late life with the median age of onset at 40 years.

The symptoms start to decline after a few weeks, and complete recovery takes about six months. Bell's palsy resolves completely without treatment in about 71% of cases with a recurrence rate of 12%. Treatment with corticosteroids has been found to increase the likelihood of improved nerve recovery.

What Causes Bell’s Palsy?

The exact cause is still unknown, but the incidence of Bell’s palsy is related to exposure to a viral infection, which causes inflammation of the facial nerve. The facial nerve passes through a narrow bony canal on its way to the face, so when it gets swollen, it affects the functioning of the facial muscles. Infections that are believed to cause it are:

Common Symptoms of Bell’s Palsy

Some of the signs and symptoms of Bell’s palsy are as follows:

Usually, the nerve on one side of the face is affected, but in sporadic cases, nerves on both sides are affected, which cause bilateral symptoms. And sometimes, Bell’s palsy can recur.

What are the Risk Factors?

Bell’s palsy can affect people of any age and gender. It has been noted that the people with the following conditions are more susceptible:

Common Complications of Bell’s Palsy

Generally, the symptoms caused due to Bell’s palsy begin to fade after a couple of weeks, and a person recovers fully within six months. But sometimes, severe cases of total paralysis cause the following complications:

How Bell's Palsy Diagnosed?

There are no confirmatory or diagnostic tests which can tell you for sure if you have Bell’s palsy. Your doctor, through various physical examination, will determine if you have facial palsy only after he or she has ruled out all the other possible conditions that can cause these symptoms like a brain tumor, stroke, Ramsay Hunt syndrome, myasthenia gravis, and Lyme disease. The doctor will look at the face, and tell the patient to perform various facial movements. They ask the patient to blink, smile, whistle, lift the eyebrows, and frown.

Other tests like magnetic resonance imaging (MRI) and computerized tomography (CT) can be used to rule out any pressure caused due to a tumor or skull fracture impinging on the facial nerve. Nerve conduction study (NCS) is used to confirm the presence of nerve damage and its severity.

What are the Treatment Options?

If you notice any signs of Bell’s palsy, get medical attention immediately as it can also be a sign of stroke. Ones a physician diagnosis it as Bell’s palsy, you can opt for home remedies and physical therapy to ease the symptoms. All the symptoms caused by Bell’s palsy are mostly temporary, and the recovery time varies depending on the severity of nerve damage. The prognosis is good if treatment is started as soon as any symptom develops.

How to Differentiate Bell’s Palsy from a Stroke?

If you experience paralysis (loss of sensation), seek medical attention immediately, as it can be a sign of stroke. Bell’s palsy causes similar symptoms to a stroke, so it is crucial to differentiate between the two. If your facial paralysis is due to a stroke, it will also affect the arms or legs of that side.

The key physical exam finding is a partial or complete weakness of the forehead. If forehead strength is preserved, a central cause such as stroke should be investigated. Findings of double vision, imbalance while walking, swallowing difficulty, slurred speech, and numbness or weakness on one side of the body will indicate an underlying stroke.

 

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Frequently Asked Questions


1.

Does Bell's Palsy Go Away?

Most of the time, Bell's palsy is not known to be permanent, but it does not go away in certain rare situations. Also, there is no discovered cure to treat Bell's palsy. However, the recovery period usually begins by two weeks to six months, starting from the onset of the symptoms. Most of the time, people affected with Bell's palsy recover full facial strength and expressions and come back to normal.

2.

Does Stress cause Bell's Palsy?

Many researchers have studied that stress can weaken the immune system and can damage the seventh cranial nerve. It is named as the facial nerve. Any damage to the facial nerve causes facial paralysis. The condition presents as one side of the affected person's face droops and becomes stiff. A Bell's palsy patient will face trouble in activities like smiling or closing the eye on the affected side of the face.

3.

Is Bell's Palsy a Sign of a Stroke?

Bell's palsy is a medical condition that causes temporary paralysis of the facial muscles, which leads to drooping and weakness on any one side of the face, and it is, most of the time, mistaken for a stroke. Unlike a stroke, Bell's palsy usually is not permanent, and it resolves by itself in a period of two weeks to six months, which depends on the severity.

4.

Is Bell's Palsy Serious?

Bell's palsy is a medical condition that usually resolves by itself with time, and it does not cause any long-term complications. However, most people affected by Bell's palsy are known to have an inability to close their eyes on the affected side of their faces during the disease process. There are some specific difficulties and can be treated symptomatically.

5.

Can High Blood Pressure Cause Bell's Palsy?

Yes, Bell's palsy is sometimes noted to be associated with disease conditions like diabetes mellitus and very high blood pressure.

6.

Does Chewing Gum Help Bell's Palsy?

The information that chewing gum helps Bell's palsy is a myth. Patients are often advised to chew gum when they are diagnosed with Bell's palsy. However, the reality is that chewing is performed by the muscles of mastication that are chiefly supplied by the trigeminal nerve. In Bell's palsy, the affected nerve is the facial nerve. Thus, chewing gums during Bell's play might, in turn, increase facial synkinesis. It will not help the condition.

7.

Is Bell's Palsy a Medical Emergency?

There are certain medical conditions, like a stroke, that might often look like Bell's palsy and are medical emergencies. Therefore, the affected individual should always seek emergent medical care if he or she notices any facial weakness or drooping. Bell's palsy might appear alarming but is only rarely serious.

8.

What Are the Recovery Signs of Bell Palsy?

Though the recovery time varies from person to person based on the severity, most affected individuals recover entirely, especially those who start to improve by three weeks after the onset of symptoms. The signs of recovery are usually a gradual decrease in the symptoms of the disease like the ability to open eyes well, and the ability to chew.

9.

What Happens If Bell's Palsy Is Untreated?

All untreated patients of Bell’s palsy do not suffer from severe complications. About one-third of the patients who do not undergo treatment for Bell’s palsy are known to be affected by health issues like spasms of the face and pain. However, some of the affected populations suffer from permanent muscle weakness due to the lack of treatment.

10.

Can I Go to Work With Bell's Palsy?

When Bell’s palsy is first diagnosed in a person, he or she should understand that they are unwell. It is important to get as much rest as possible even if the person has no other symptoms. The affected person should also follow a healthy diet. If the person is at work or school, it might be necessary to take some time off to recover. Still, if the person feels mentally strong, the person can still work if needed.

11.

How Can I Recover From Bell's Palsy Fast?

The following are different ways for a speedy recovery from Bell's palsy. Always do not panic. Consult the doctor at once the symptoms are experienced and follow the doctor's recommendations strictly. Take adequate rest and sleep as much as possible. Avoid going to work for at least several days until you adapt to the disease condition. Protect your affected eye from getting dry. Follow up properly as recommended by the doctor.

12.

What Should I Eat If I Have Bell's Palsy?

A healthy diet is very mandatory for functional recovery from Bell's palsy. However, it is good to avoid certain hard foods, chewy foods since these foods can be challenging to chew. So, choose a soft, natural chew diet like foods that include pasta, fish, deeply cooked meats, and vegetables. Also, try smaller mouthfuls of foods since that could be easier to control and less likely to spill your food from your mouth.

13.

Do Facial Exercises Help Bell Palsy?

Yes, facial exercises help with the prognosis of Bell's palsy patients. It helps by increasing muscle strength and also improving the coordination in the face. In that way, Bell's palsy patients could improve their capability in performing certain facial movements like jaw and mouth movements.

14.

How Do You Smile With Bell's Palsy?

The facial weakness caused during Bell's palsy makes half of the affected person's face appear to be dropped. Their smile is one-sided, and their eyes on the affected side resist to close normally.

15.

Is Vitamin B12 Good for Bell's Palsy?

Vitamin B12 formulations have been showing to be very beneficial to people who are affected by Bell's palsy. Vitamin B12 deficiency could lead to nerve degeneration. Therefore, both oral tablets and also injected vitamin B12 are being used to treat many types of nerve disorders like the Bells' palsy.

16.

Why Is Bell's Palsy So Painful?

In Bell's palsy, pain and discomfort are usually noted to occur on one side of the face or head. This condition mainly results due to the sudden unexplained damage to the facial nerve that can be because of many causes.

17.

Will My Face Go Back to Normal After Bell's Palsy?

Many people note an improvement in their symptoms like weakness and inability to close their eyes on the affected side after two to three weeks. Still, complete recovery can happen after a period ranging between three and six months. While most people recover with treatment, only some patients are left with some degree of permanent facial weakness, mainly due to the lack of proper medical care.

18.

How Is Bell's Palsy Transmitted?

Bell's palsy is a medical condition that occurs when the seventh cranial nerve known as the facial nerve becomes swollen or compressed due to any cause. That, in turn, results in facial weakness or paralysis. The exact etiology of this damage is unknown, but many researchers believe a viral infection mostly triggers it.

19.

Where Do You Massage for Bell's Palsy?

Facial massage in people affected with Bell's palsy can help alleviate the disease’s symptoms and maintain adequate flexibility and circulation in those affected muscles. The massage should be done at the affected side of the face involving all muscles from the forehead to the chin.

20.

How Do You Know Bell's Palsy Is Getting Better?

In Bell's palsy, there are sure signs of recovery usually that include the ability to smile correctly, to squint, blinking, or closing the eyelid, which is not typically possible easily during the disease. Patients in their recovery course also tell that their feelings in their faces feel back to normal as before.

21.

Are There Any Home Remedies for Bell's Palsy?

Along with a healthy diet, you can do your physical therapy exercises as instructed by your physiotherapist. Massaging and exercising your face frequently according to your physical therapist's advice will help in relaxing your facial muscles. Above all, adequate rest is mandatory to speed up the disease process.

22.

Can Bell's Palsy Affect the Brain?

In some mild cases of Bell's palsy, the recovery is very rapid. Therefore there is damage only to the myelin sheath of the facial nerve. The brain is not affected by Bell's palsy.

23.

What Are the Long Term Effects of Bell's Palsy?

Bell's palsy is a disease that usually resolves itself with time, and it does not cause any long-term complications. However, most people affected by Bell's palsy are known to have an inability to close their eyes on the affected side of their faces during the disease process. These are the difficulties during the disease that can be treated symptomatically.

24.

Is Bell's Palsy an Autoimmune Disease?

Studies suggest that Bell's palsy is most probably an autoimmune condition. A viral infection might prompt an autoimmune reaction against a segment of the peripheral nerve myelin, leading to the demyelination of the facial nerve.

Last reviewed at:
25 Jan 2019  -  5 min read

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Dr. Devavrat Harihar Nene

Dr. Devavrat Harihar Nene

MD Medicine, DM Neurology

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