Bell's palsy

It is also called idiopathic peripheral facial palsy. Bell’s palsy is a neurological disorder that weakens or paralyzes facial muscles. It happens suddenly and can get worse over 48 hours. People with Bell’s palsy develop a droopy appearance on one (sometimes both) sides of their faces. This happens because the 7th facial nerve gets inflamed due to injury or trauma along its path inside your head. Bell’s palsy can affect men and women equally at any age. It's more common in pregnant women and diabetes patients, influenza, and other upper respiratory diseases. It's not as frequent before 15 or after 60.

Bell’s palsy name comes from Charles Bell, a Scottish anatomist who described it first.

Bell palsy is not considered permanent. But in rare cases, it doesn't disappear. There's no known cure for Bell's palsy yet. Most people with Bell palsy recover full facial superpowers.

Bell's palsy or Facial paralysis

Causes of Bell's palsy

Inflammation and compression of cranial nerve vii are the main causes of Bell’s palsy. The seventh cranial nerve also called the facial nerve, connects the brain to the muscles that control facial expression. Cranial nerve VII is additionally included with taste and ear sensation. According to the National Institute of Neurological Disorders and Stroke Trusted Source, facial nerve inflammation reduces blood flow and oxygen to the nerve cells. This harm to the cranial nerve and nerve cells can cause paralysis of the facial muscles.

The exact mechanism of Bell's palsy is unknown, it's often related to a viral infection. Researchers have found some viruses that have been linked to Bell's palsy including:

• Herpes simplex virus (a virus that causes mouth infections, like cold sores).
• Varicella-zoster infection (chickenpox and shingles).
• Epstein-Barr infection (mononucleosis).
• Adenoviruses (Respiratory illnesses).

Symptoms of Bell’s palsy

In uncommon cases, Bell`s paralysis can affect both sides of the face. Symptoms appear suddenly within 48 to 72 hours and usually improve after a few weeks. The symptoms of Bell's palsy vary in individuals and can range from mild to severe. People with facial Paralysis usually regain some or all of their facial function within a few weeks to six months. In some cases, the facial paralysis can last longer or become permanent.

Symptoms of Bell’s palsy include:

• Sudden weakness (on one side of the face)
• Drooping eyebrows and mouth
• Drooling from mouth
• Trouble during closing an eye
• Pain behind the ear on the affected side of Bell's palsy
• Excessive tearing in one eye
• Problems eating and drinking

Risk factors for Bell’s palsy

The risk of Bell's palsy may increase in people with:

• Pregnancy (during 3rd trimester or 1st week after giving birth).
• Diabetes.
• Obesity.
• High blood pressure (hypertension).

Diagnosis of Bell's palsy

Bell's palsy can be diagnosed by taking a health history and physical examination (check for upper and lower facial muscle weakness).  A doctor can usually accurately diagnose Bell’s palsy based on the history of symptoms and examination alone. But they may sometimes suggest one or more of these tests:

Blood tests to look for medical problems such as Lyme disease.

Electromyography (EMG) to measure nerve activity and damage that control facial muscle.

Magnetic resonance imaging (MRI).

Computed tomography (CT) scans.

Treatment of Bell's palsy

Often, There is no need for treatment for Bell's palsy. Symptoms begin to improve right away. But, it may take time (weeks or even months) for the muscles to recover. Still, the doctor may prescribe:

• Eye drops or eye ointments if your eye can’t close completely, you may need to wear an eye patch to protect that eye from drying. Eye care is important to prevent damage to your cornea, a serious complication of Bell’s palsy.

• Oral corticosteroids (like prednisone) can help reduce nerve swelling. It may assist you to regain facial movement quickly. This treatment is most effective when you start it within 48 hours of noticing symptoms.

• Antiviral medications may be prescribed to fight the virus that may cause Bell's palsy and speed up recovery. This treatment is more beneficial when it's combined with oral corticosteroids.

• Some providers may recommend electrical stimulation to prevent facial muscle loss after Bell’s palsy, studies haven’t shown any benefit of this treatment.