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Bell's Palsy

What is Bell's Palsy ?

In Bell's palsy, impulses from the seventh cranial nerve-the nerve responsible for motor innervation of the facial muscles-are blocked. The conduction block results from an inflammatory reaction around the nerve (usually at the internal auditory meatus) and produces unilateral facial weakness or paralysis.

Bell's palsy was named after Sir Charles Bell, a 19th century doctor who first described the condition and linked it to a problem with the facial nerve.

Although Bell's palsy affects all age-groups, it occurs most often in people ages 20 to 60. Onset is rapid. In 80% to 90% of patients, the disorder subsides spontaneously, with complete recovery in 1 to 8 weeks. Recovery may be delayed in elderly people. If recovery is partial, contractures may develop on the paralyzed side of the face. The disorder may recur on the same or the opposite side of the face.

Whats causes bell's palsy?

Viral infections such as herpes, mumps, or HIV, and bacterial infections such as Lyme disease or tuberculosis can cause inflammation and swelling of the facial nerve that causes Bell's palsy. A tumor, skull fracture, or neurological condition caused by chronic disease (e.g., diabetes, Guillain-Barre syndrome) can also lead to Bell's palsy.

Signs & Symptoms of Bell's Palsy

The major symptom of Bell's palsy is one-sided facial weakness or paralysis. Muscle control is either inadequate or completely missing. There may also be involuntary facial movements, such as twitches, that accompany certain facial expressions. Afflicted individuals frequently have difficulty shutting the affected eye and may not be able to close it at all.

Diagnostic Tests

Often, doctors can identify Bell’s palsy simply by examining the face and listening to a description of the symptoms. If there is any doubt, an electromyography (EMG) test may be carried out to measure the electrical activity of the facial muscles. If symptoms have not started to improve within three weeks, or are unusual, the doctor may arrange an imaging tests like an MRI or CT scan, which take pictures of the inside of the head, to make sure nothing else is causing the facial weakness.

Treatment

Appropriate treatment consists of prednisone, an oral corticosteroid that reduces facial nerve edema and improves nerve conduction and blood flow. Prednisone treatment is especially helpful when begun in the 1st week after the disorder's onset. After the 14th day of prednisone therapy, electrotherapy may help prevent facial muscle atrophy.

Analgesics are used to control facial pain and discomfort. Heat may also be applied to the affected side to provide comfort.

If the patient fails to recover from facial paralysis, surgery that involves exploration of the facial nerve may be necessary.

Many patients incorporate alternative health care remedies such as acupuncture, traditional Chinese medicine (TCM), and homeopathy regimens into their treatment. Facial exercises may improve muscle tone and help the facial nerve recover. Exercises for Bell's palsy patients have been developed by physical therapists and other specialists.

Prevention Tips

Currently, there is no way to prevent Bell's palsy. 



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