Bell’s Palsy

By:    Published: July 3, 2012

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Bell’s palsy is a term used to describe facial paralysis that occurs on one side of the face as a result of damage to facial nerves that control muscle movements in the face. The condition can occur at any age.

Definition

Bell’s palsy is a condition in which the seventh cranial nerve in the face is damaged. The seventh cranial nerve is responsible for controlling muscle movement in the face. When the nerve is damaged, facial muscles become weak and muscle paralysis can occur.

Although the exact cause for the condition is unknown, facial nerves on one side of the face are affected by swelling and inflammation. It is possible that this may occur as a result of a viral infection, though it is possible that other conditions may cause the disorder as well.

Symptoms

Symptoms of Bell’s palsy generally develop rather suddenly, but can sometimes develop slowly over a 2-3 day period. Once all symptoms are present, they do not increase in severity. Some individuals will develop symptoms after suffering from a cold virus.

When symptoms do occur, they are present only on one side of the face. Sometimes, the nerves on both sides of the face can be affected, but this is extremely rare. Symptoms can range from mild muscle weakness to complete facial paralysis.

The most common symptoms of Bell’s palsy include:

  • Stiffness in facial muscles on one side
  • Feeling of facial muscles pulling to one side
  • Difficulty eating and drinking
  • Inability to hold food in mouth on one side
  • Drooling
  • Facial drooping in the eyelid or corner of the mouth
  • Difficulty closing one eye
  • Difficulty smiling or making facial expressions
  • Muscle weakness in the face

Other, less common symptoms may occur, such as:

  • Dry eyes
  • Dry mouth
  • Headache
  • Loss of taste
  • Increased hearing in one ear
  • Facial twitching
  • Pain in the jaw

Causes

No exact cause for Bell’s palsy has been identified. In many cases it is believed to be the result of a reaction to a cold virus or other viral infection. The most common viruses that are believed to play a role in the development of Bell’s palsy include:

  • Genital herpes
  • Chickenpox
  • Shingles
  • Epstein-Barr (Mononucleosis)
  • Cytomegalovirus
  • Adenovirus (Respiratory infection)
  • Rubella
  • Mumps
  • Coxsackievirus (Hand-foot-and-mouth-disease)

In rare cases, some individuals will experience recurring attacks of Bell’s palsy. This is believed to be the result of a genetic predisposition to the condition. Other possible causes include stroke, Lyme disease or a brain tumor.

Risk Factors

Although Bell’s palsy can affect people of any age, there are certain factors that put individuals at risk of developing the condition. Pregnant women, especially those in their third trimester, as well as women who have recently given birth are at an increased risk. Individuals who have recently suffered from a cold or other viral infection are more likely to develop Bell’s palsy.

Complications

Most cases of Bell’s palsy will clear up completely within a few weeks. Occasionally the condition will last for a few months. Some individuals may experience long-term or permanent symptoms, such as changes in taste, muscle spasms, eyelid twitches and weakened facial muscles.

Less common complications include eye ulcers or infections due to excessive drying of the surface of the eye. These complications are less likely to occur in individuals who did not lose all of their nerve function and whose condition start to improve within three weeks from the onset of symptoms.

Diagnostic Tests

A health care provider will likely be able to diagnose Bell’s palsy after administering a health history report and performing a basic physical examination. There is no specific diagnostic test for Bells’ palsy. Your doctor may perform a nerve conduction test or electromyography to check the condition of the nerves in the facial muscles. To rule out a brain tumor, if it is suspected, your physician may send you for additional tests, such as an x-ray, CT scan and/or MRI.

Treatment Options

Treatment options for Bell’s palsy are limited. In the majority of cases, the condition will clear up on its own without treatment. It can take several weeks or even month for the muscles in the face to regain their normal strength. Treatment is geared toward alleviating discomfort. Treatment options include:

  • Eye drops or ointment to keep the eye moist
  • An eye patch to wear while sleeping
  • Corticosteroids to reduce swelling in the nerves
  • Anti-viral medications
  • Physical therapy to prevent muscle atrophy

Alternative Medicine

There is not a lot of scientific evidence to support the use of alternative medicine to treat Bell’s palsy. Some people who suffer from the condition may benefit from alternative therapies such as:

  • Facial massage to prevent muscle atrophy
  • Mediation and yoga to relieve muscle tension and alleviate pain
  • Acupuncture to stimulate nerves and muscles
  • Biofeedback training to gain better control over facial muscles
  • Vitamin B therapy to help induce nerve growth

Home Remedies

Home care measures can bring relief of symptoms and help speed recovery. When Bell’s palsy prevents the eyelid from shutting, it increases the risk of dry eyes and eye injury. Be sure to use lubricating eye drops to keep your eye moist during the day and an eye ointment at night.

Many doctors recommend the use of eyeglasses or goggles to protect the eyes from getting injured during the day, and an eye patch at night. Over-the-counter pain relief medications can be effective at alleviating pain. A warm wet washcloth placed over the face several times a day can also help alleviate pain and reduce swelling.

It is important to continue to perform any self-help therapies that were recommended by your doctor, such as physical therapy exercises and facial massage.

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