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Published on Jan 25, 2019 - 5 min read
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, 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.
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:
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.
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:
Diabetic patients.
Pregnant women, especially during the third trimester and a week after delivery.
People suffering from an infection of the upper respiratory tract, like cold and flu.
And people suffering from any viral infection.
People with a family history of this condition.
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:
The facial nerve gets damaged irreversibly.
Synkinesis - It is the involuntary contraction of muscles when you are trying to move some other muscles. This is caused due to abnormal re-growth of the nerve fibers. For example, when the person tries to smile, the eye in the affected side close on its own.
Because of the inability to close the eyelids, the eye becomes dry. Partial or complete blindness results due to this dryness and scratching of the cornea.
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.
Medications - Anti-inflammatory medicine like corticosteroids (Prednisone) are prescribed. This brings down the swelling of the facial nerve. Antiviral drugs like Valacyclovir is also prescribed, but its role in the treatment of Bell’s palsy is still not clear. As the eyelids resist closing, use lubricating eye drops to keep the eyes from getting dry. Wear protective glasses or an eye patch to protect the affected eye. Painkillers are prescribed to relieve pain.
Physical Therapy - To prevent the paralyzed muscle from shrinking, a physical therapist teaches massages and exercises of the facial muscles. This may also include electrostimulation of facial nerve, however, the results of this procedure are unclear.
Surgery - In very rare and severe cases, decompression surgery is done to relieve the pressure on the facial nerve.
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.
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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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.
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.
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.
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.
Yes, Bell's palsy is sometimes noted to be associated with disease conditions like diabetes mellitus and very high blood pressure.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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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