What is Bell’s palsy?
Bell’s palsy, also known as acute peripheral facial palsy, is a condition that is characterized by a sudden weakness in the facial muscles. In most cases, this weakness is temporary and significantly improves within weeks. This weakness makes half of your face appear drooping. You cannot smile or close your eye in the affected side of your face.
Bell’s palsy can occur at any age. The exact cause is not known. However, it is thought to be caused by swelling and inflammation of the nerve that controls the muscles on one side of your face. Or it may be a reaction that occurs after a viral infection.
Bell’s palsy is temporary for most people. Symptoms usually begin to improve within a few weeks, and the disease is completely cured in about six months. In a few people, some symptoms of Bell’s palsy last a lifetime. And Bell’s palsy may reappear in rare cases.
Signs and symptoms of Bell’s palsy appear suddenly and may include:
- Mild weakness that turns rapidly into complete paralysis on one side of your face – this happens within hours to days.
- Face drooping and difficulty using facial expressions, such as closing your eyes or smiling.
- Feeling of pain around the jaw or behind the ear on the affected side
- Loss of the sense of taste
- Increased sensitivity to sound on the affected side.
- Changes in the amount of saliva and tears your glands produce.
Although the main cause of Bell’s palsyis unknown, it is usually linked to a viral infection. The viruses that have been found to be related to Bell’s palsy are viruses that cause the following diseases:
- Cold sores and genital herpes
- Hand, foot and mouth disease (Coxsackie)
- Chickenpox and shingles
- German measles
- Mononucleosis infectious disease
- Cytomegalovirus infection
- Respiratory diseases
The nerve that controls the facial muscles passes through a narrow, bony pathway on its way to your face. In Bell’s palsy, this nerve becomes inflamed and swollen, usually due to a viral infection. Besides the facial muscles, this nerve controls tears, saliva, taste and a small bone in the middle of your ear.
The following are at a higher risk of Bell’s palsy:
- Pregnant women, especially in the last three months
- People with an upper respiratory infection, such as the flu
- Diabetic patients
There is no specific test for Bell’s palsy. Our neurologist will look at your face and ask you to, for example, move your facial muscles by closing your eyes, raising your eyebrow, and showing your teeth and frowning.
Other conditions, such as stroke, infection, Lyme disease, and tumors, can weaken the facial muscles which mimics Bell’s palsy. If the causes of your symptoms are not clear, your doctor may recommend other tests, including the following:
- Electromyogram (EMG). The test can check for and determine nerve damage. An electromyogram measures the electrical activity of a muscle in response to triggering factors and the conduct of electrical impulses in the length and speed of a nerve.
- Radiology. Magnetic resonance imaging (MRI) or computed tomography (CT) may be needed in some cases to rule out other possible causes of pressure on the facial nerve, such as a tumor and a skull fracture.
How is Bell’s palsy treated?
Most people recover from Bell’s palsy with or without treatment. Moreover, there is no one specific treatment that works for all patients. The doctor may prescribe medications or physiotherapy to speed up the recovery process.
Corticosteroids, such as prednisone, are powerful anti-inflammatory agents. If you can reduce the swelling of the facial nerve, you will feel more comfortable. Corticosteroids may work better if they are started within a few days of your symptoms appearing.
Paralyzed muscles can cause continuous contractions. Our physiotherapist can teach you how to massage and exercise your facial muscles to help prevent this from happening.