Bell's Palsy

Bell's palsy indicates a condition of paralysis of face muscles. It is a temporary problem that is the result of an injury to the facial nerve, the cranial nerve VII.

This damage may lead to a loss of facial expressions and a droopy appearance. Though it’s not a fatal condition, it can create problems of self-respect.

Prevalence and Course

Bell’s palsy is a common condition which affects 40, 000 people residing in the USA. It is prevalent globally with a high incidence rate. The risk of its occurrence increases with the age of a person.

The course of the condition depends on the reason and degree of the injury to the facial nerve; it may be short and sudden with a person recovering by himself/herself.

Description

Inflammation of the facial nerve may lead to a disruption of normal functioning. The face is affected and a person cannot express his/her emotions via the face. A person may acquire a sad look on the one side. Bell’s palsy can occur at any age but its recurrence is not common. A person with Bell’s palsy has a typical look while there is a loss of wrinkling on the affected side of the nerve.

The disease is named after Sir Charles Bell, a Scottish surgeon who first researched this facial nerve and its supply many years back.

Causes of Bell's Palsy

There are a variety of conditions that can lead to a damaged facial nerve. Most commonly, facial nerves are damaged by infections such as the herpes zoster infection, adenovirus infection, mononucleosis caused by the Epstein bar virus or cytomegalovirus infections. HIV and middle ear infections by any organism can also lead to Bell’s palsy by damaging the facial nerves.

Diseases in which Bell’s palsy are likely to occur include Lyme disease, brucellosis, Sarcoidosis, Stroke, a trauma to head and neoplasia of the brain.

Symptoms

The facial nerve innervates the muscles of the face, causing their contraction, plus produces tears and functions to convey the taste sensation of the anterior two thirds of the tongue. When this nerve is damaged, all these functions will be affected. The symptoms are mainly the result of an injury of the facial nerve and may vary among different people.

Common symptoms are sagging of the mouth, weakness, twitching, eyelid dropping or difficult closure, drooling, dribbling of saliva, lacrimation on one eye, headaches and an impairment of the taste sensation. 

A person may experience buzzing in the ears, increased sensitivity to noises, speech impairment, pain around jaw and temporal area and difficulty eating or drinking.

When to see a Doctor

If you experience a problem eating or clenching teeth due to weakness of the muscles or face or find it difficult to close one eye or that your face is distorted, visit your doctor immediately for better support and treatment. He/she will then rule out any other cause and provide treatment accordingly. 

Diagnosis

Diagnosing this condition does not require any special lab investigation. Diagnosis is made on the history and physical examination of a patient. However, in order to exclude other possible causes some tests may be done and these include an x-ray and MRI. 

Treatment

Treatment is mainly achieved with the correction of underlying etiology. For viral infections, an anti-viral treatment is recommended.  Steroids can be given for a short period of time. A facial massage prevents the development of a permanent type of problem due to muscle paralysis.  Physiotherapy is beneficial too.

Risk Factors

• Genetic association
• Pregnancy
• A trauma to the head or ear
• Diabetes mellitus
• Flu
• Cold