Throughout our lives, thousands of possible diseases and health problems can affect us without any clear explanation. However, knowledge allows us to seek treatment alternatives or even preventive measures. That’s why today we will talk about a little-known syndrome, called Bell’s palsy.

What is Bell’s Palsy?

Bell’s palsy is a type of facial paralysis resulting from damage or trauma to the facial nerves. It is a condition that causes temporary weakness or loss of movement in some muscles of the face. It may occur when the nerve that controls the facial muscles becomes inflamed, swollen, or compressed. The condition affects only one of the facial nerves and one side of the face; however, in rare cases, it can affect both sides. This causes the affected side to appear droopy or stiff. People with Bell’s palsy may have difficulty smiling or closing the eye on the affected side of the face. In most cases, it resolves after a few weeks, and although it can occur at any age, this condition is most common in people between 16 and 60 years old.

Why the Name Bell’s Syndrome

Bell’s palsy received its name after Charles Bell, a 19th-century Scottish surgeon and anatomist, described how the facial nerve works and its link to the disease.

Causes of Bell’s Palsy

Each side of the human face has a nerve. The facial nerve (also known as the seventh nerve) exits the brain and passes through a small tunnel in the skull just below the ear. These facial nerves control the muscles on both sides of the face, allowing the movements of opening and closing the eyes, blinking, and facial expressions like smiling and frowning. Additionally, the facial nerve carries nerve impulses to the tear glands, the salivary glands, and is also involved in taste sensations in the tongue. When Bell’s palsy occurs, the function of the facial nerve is interrupted, disrupting the messages the brain sends to the facial muscles. This interruption results in facial weakness or paralysis. The exact cause of Bell’s palsy is unknown, but many medical researchers believe that its occurrence is likely triggered by viral infections. This is because such infections cause swelling and compression, compromising the facial nerve’s function.

Main Viruses Linked to Bell’s Palsy

The following viruses are commonly associated with Bell’s palsy:

  • Cold sores and genital herpes
  • HIV, which damages the immune system
  • Chickenpox and shingles
  • Mononucleosis (Epstein-Barr)
  • Cytomegalovirus infections
  • Respiratory illnesses caused by adenovirus
  • Rubella
  • Flu (influenza B)
  • Hand, foot, and mouth disease
  • Lyme disease, a bacterial infection caused by infected ticks

Symptoms of Bell’s Palsy

The symptoms of Bell’s palsy can develop one to two weeks after an ear infection, or even after an eye infection. They appear suddenly and, in most cases, reach their peak within 48 hours, leading to significant facial distortion. The severity of weakness varies depending on whether the nerve is partially or completely affected. The signs and symptoms of Bell’s palsy include:

  • Drooping of the eyelid and corner of the mouth
  • Difficulty keeping saliva in the mouth
  • Difficulty eating and drinking
  • Inability to make facial expressions, such as smiling or frowning
  • Facial weakness, only one side moves
  • Muscle spasms in the face
  • Dizziness
  • Dry eye and mouth
  • Headache
  • Sensitivity to sound
  • Difficulty with speech
  • Loss of ability to taste food
  • Discomfort around the jaw and behind the ear

Risk Factors for Bell’s Palsy

The risk of developing Bell’s palsy increases if these conditions are present:

  • Pregnancy
  • Diabetes
  • Lung infection
  • Kidney infection
  • Family history of the paralysis

How is Bell’s Palsy Diagnosed?

The diagnosis of Bell’s palsy is based on clinical presentation, questions about the symptoms, how long they have been present, observation of the distorted facial appearance and inability to move muscles on the affected side of the face, ruling out other possible causes of facial paralysis. There is no specific laboratory test to confirm the diagnosis of the disease. Generally, the doctor may perform a test called electromyography (EMG), which can confirm nerve damage, determine the severity and extent of weakness in the facial muscles. In most cases, this weakness is limited to one side of the face or occasionally isolated in the forehead, eyelid, or mouth. Blood tests can sometimes help diagnose other coexisting problems, such as diabetes or the presence of a bacterial or viral infection. An MRI or CT scan may rule out other causes of pressure on the facial nerve.

Diseases That Can Be Confused With Bell’s Palsy

Bell’s palsy is a common cause of facial paralysis. Other less common causes caused by other conditions that damage or affect the facial nerve may include: head trauma, sarcoidosis, Lyme disease, tumors in the ear, tumors in the parotid gland, and brain tumors. Additionally, some people who have had a stroke may develop facial weakness. However, these conditions are generally associated with other symptoms, helping differentiate diagnoses. Some of these symptoms are:

  • In stroke cases, other muscles besides the facial muscles are likely to be affected, such as the arm or leg
  • In tumors, symptoms generally develop slowly (over weeks or months), whereas Bell’s palsy is sudden, usually “overnight”
  • Conditions such as sarcoidosis and Lyme disease tend to cause other symptoms besides nerve paralysis
  • In particular, Bell’s palsy is rare in children under 10 years old. Other conditions should be carefully ruled out in children who develop facial weakness.

How is Bell’s Palsy Treated?

Bell’s palsy affects each individual differently. Some cases are mild and do not require treatment because symptoms generally subside on their own within 2 weeks. For others, treatment may include medications and other therapeutic options. If an infection is found to be the cause of Bell’s palsy, targeted treatment can resolve the problem. Recent studies have shown that steroids are effective in treating the paralysis. The following treatments may help with recovery.

Medication

Corticosteroid medications that reduce inflammation and swelling. Antiviral or antibacterial medication used to fight herpes viral infections may also help shorten the course of the disease. Pain relievers can help relieve mild pain. Lubricating eye drops, such as artificial tears, ointments, or gels, are also effective. Due to possible drug interactions, people taking prescription medication should always consult their doctor before taking any over-the-counter medication.

Home Treatment

Another important factor in treatment is eye protection. Bell’s palsy can interrupt the natural ability to blink or close the eyes, leaving them exposed to irritation and dryness. Therefore, keeping the eye moist and protected from debris and injury, especially at night, is extremely important.

  • Placing a warm, moist towel over the face can relieve pain
  • Facial massage
  • Therapies such as acupuncture may offer potential improvement in nerve function and pain.

Physical Therapy

Muscles paralyzed by the condition may shrink and waste away, causing permanent contractures. Physical therapists can help by teaching exercises and massage for the facial muscles to recover, or to avoid this complication.

Possible Complications of Bell’s Palsy

Most people who have an episode of Bell’s palsy will recover completely without complications. However, complications can occur in more severe cases of Bell’s palsy. These include:

  • Irreversible damage to the facial nerve
  • Involuntary muscle contraction – which is when moving one part of the body causes another part to move involuntarily. For example, your eye may close when you smile.
  • Excessive eye dryness, which can lead to eye infections, ulcers, or even blindness.

Is There Surgery for Bell’s Palsy?

In general, decompression surgery (to relieve pressure on the nerve) for Bell’s palsy is controversial and rarely recommended. In rare cases, cosmetic or reconstructive surgery may be necessary to reduce deformities and correct damage, such as an eyelid that will not close completely or an uneven smile.

Does Bell’s Palsy Have a Cure?

Yes, Bell’s palsy can be cured. The prognosis for individuals with Bell’s palsy is generally very good. The extent of nerve damage determines the extent of recovery. Improvement is gradual and recovery times vary. With or without treatment, most people begin to improve within 2 weeks of the onset of symptoms, and most recover completely, returning to normal function within 3 to 6 months. For some, however, symptoms may last longer. In some cases, symptoms may never completely disappear. In rare instances, the disorder can recur, on the same or opposite side of the face.

Prevention

Since the causes of Bell’s palsy are unknown, there are no ways to prevent the disease. However, research is ongoing into brain and nervous system disorders, including Bell’s palsy. These studies focus on increasing understanding of how the nervous system works and what causes it to fail in certain situations, leading to dysfunction. Learning more about the circumstances that lead to nerve damage and the conditions that can cause nerve injury. Knowledge gained from this research may help scientists find the definitive cause of Bell’s palsy, leading to the discovery of new effective treatments for the disorder. They also aim to develop methods to repair damaged nerves and restore full use and strength to injured areas, as well as find ways to prevent nerve damage and injury.

When to Seek Help?

Call your doctor immediately if you are showing signs of Bell’s palsy. Prompt treatment can help speed up recovery time and prevent any complications. See also: Childhood Cerebral Palsy Photos: Patrick J. Lynch