Bell’s palsy is a type of paralysis or weakness of one side of the face. As with many diseases, it is named after the doctor who first described the symptoms. Bell’s palsy is thus named after Sir Charles Bell who first identified the disease in the 1800’s.
The symptoms can appear quite suddenly, or they can become progressively more severe over a period of several days. Most people who experience Bell’s palsy will have a precipitating event, such as a cold, stressful event, or a stiff neck or shoulder. This is not mean you’re going to get Bell’s palsy if your neck is stiff however.
The exact cause of Bell’s palsy is not well understood. The most likely explanation is that the paralysis is caused by transient damage to the facial nerve. The facial nerve is responsible for controlling the muscles in your face. These muscles do everything from making you raise your eyebrows, to smiling and kissing. Damage to the facial nerve can be caused by a viral infection, or possibly be autoimmune in nature. Viruses which have been implicated in the development of Bell’s palsy include herpes zoster, otherwise known as shingles. Rubella, mumps, influenza, and the virus causing mononucleosis (Epstein-Barr) have all been associated with Bell’s palsy.
Bell’s palsy can also be caused by a lack of blood flow or pressure to the facial nerve as it comes out of the skull. An example of this would be a slow-growing tumor which presses on the nerve. Again, just because you get Bell’s palsy does not mean that you have brain cancer.
Bell’s palsy can be quite distressing, but is rarely a serious long-term problem. It is never dangerous or life-threatening. The time it takes to recover, and the severity of the symptoms, is related to the amount of damage suffered by the facial nerve.
Mild cases of Bell’s palsy can see a complete recovery within several months. More severe cases can require long-term rehabilitation. Most people with Bell’s palsy have a complete recovery, although approximately 10 to 20% will retain some symptoms for a long time.
Symptoms of Bell’s palsy can be quite striking and distressing to the affected person and those around them. Muscles in the face will become progressively weaker, often to the point of complete paralysis. This usually only happens on one side of the face, with the unaffected side been left completely functional.
The side of the face which is affected will become flat and expressionless, almost as if the person were half zombie. Smiling, frowning, kissing, and moving the muscles around your eye and eyebrows becomes difficult or impossible.
Oftentimes a person will experience some pain around the ear on the affected side. This is because the facial nerve is responsible for some functions in the ear. Aside from this, Bell’s palsy is typically not painful.
Because the muscles around the cheeks and mouth are effected, people often have difficulty keeping their lips together. This can lead to accidental drooling.
If you are unable to blink, your eyes can become quite dry and irritated rather quickly. Dust, dirt, and other particles that are swept away when you unconsciously blink throughout the day become stuck on the eye. If this dust is not cleaned frequently, corneal damage can result.
In most cases Bell’s palsy is able to be diagnosed clinically, without extensive testing. Simply looking at the affected person makes the diagnosis somewhat obvious. Determining the exact cause can be more complicated. If a person recently had an infection, such as a cold or influenza, often that is enough to determine the cause. In some rare cases a doctor may want to get a CAT scan of the head to look for possible causes of nerve damage. This is not routinely done however.
It should be noted that the facial nerve paralysis caused by an infection with Lyme’s disease is technically not Bell’s palsy. Facial nerve palsies caused by Lyme’s disease are more frequently found on both sides the face, and typically lasts less than two months.
A series of tests known as electromyography can be done to determine the extent of damage to the facial nerve. This helps a doctor make a prediction as to the severity of the disease and amount of time it will take to recover. Electromyography is only diagnostic, not a treatment.
Treatment and Care
Most cases of Bell’s palsy will recover on their own over time. Some doctors will recommend cortisone injections into the affected nerve, although this therapy is mildly controversial and has had variable efficacy.
Eyes must be protected from dust and dirt as long as blinking is not possible. This can be done with long-lasting eyedrops, and the use of protective goggles or glasses. Using an eye patch at night can help prevent damage to the eye while you sleep. In very rare cases, surgery may be able to release pressure on the facial nerve and relieve symptoms.
If you suspect that you or someone you know may be suffering from Bell’s palsy, contact your doctor. Although Bell’s palsy is not a medical emergency, the symptoms can become quite debilitating and should be addressed by a medical professional as soon as possible.