Bell's Palsy

By Author: Sajid Latif
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Bell's palsy

What is Bell's palsy?

Bell's palsy is a common condition that results in weakness or total paralysis of one half of the face. It usually recovers spontaneously.

What causes Bell's palsy and who is at risk?

Bell's palsy affects men and women equally and may occur at any age and at any time of year. It is likely that a number of different viruses may trigger the process but this remains unproven.

The condition is caused by swelling of the facial nerve, which activates the muscles of the face, as it passes from the brain through a narrow bony canal. This swelling results in loss of the covering layers of the nerve fibres or damage to the nerve fibres themselves.

What are the common symptoms and complications of Bell's palsy?

Symptoms begin to occur over a short period of time and full weakness of the face usually occurs after two to five days. Early symptoms may include pain in or behind the ear. This is followed by a rapidly worsening weakness of one half of the face. It becomes difficult to close one eye completely, and one corner of the mouth on the same side begins ...
... to droop.

Other common symptoms include loss of taste and intolerance of loud noises in the ear of the affected side of the face. Some people also experience altered sensation in the face on the side of the weakness..

Occasionally, the damage may be permanent, if the affected nerve fibres re-grow to a different muscle in the face. This may cause you to move the corners of your mouth when you close your eyes. Rarely, it may cause tears to form spontaneously when you produce saliva — this phenomenon is known as crocodile tears.

How do doctors recognise Bell's palsy?

Your doctor may be able to make a preliminary diagnosis of Bell's palsy by considering your symptoms and how they developed, and looking at your face while asking you to try to move your facial muscles. If after a few days there is doubt about the diagnosis, a test called electromyography (EMG) can confirm the presence of nerve damage and determine its severity. It does so by measuring the electrical activity of your facial muscles. When muscles are active, they produce an electrical current - the stronger the muscle, the greater the current. An EMG is given in outpatients. Fine needles are inserted into one of the muscles to be tested. A wire connects the needles to an electronic device which records and displays the patterns of electrical activity when the muscle is at rest and as you voluntarily tighten it.

What is the treatment for Bell's palsy?

This condition gets better on its own with complete recovery as the rule, therefore, often no treatment is given.

Steroid tablets may be helpful in speeding recovery if taken very early in the course of the illness but there is little scientific evidence to support this.

The few patients who have permanent facial paralysis may be helped to cope with the problem. Methods used include eyelid weights or springs, and a special form of physical therapy called facial retraining. Occasionally, the muscles may be operated on, or treated with chemical injection (e. g. of botulinum).

What is the outcome of Bell's palsy?

Bell's palsy is not a serious condition but can lead to complications such as irritation of the eye. Most people get better without any treatment. Even patients with permanent facial nerve injury can be helped.

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