Bell’s Palsy

What is Bell’s palsy?

Bell’s palsy is a non-progressive neurological disorder of the 7^th cranial facial nerve. It is characterized by the sudden onset of facial paralysis resulting from decreased blood supply and/or compression of this nerve.

What causes Bell’s palsy?

The exact cause behind the sudden decrease in blood supply is not exactly known. However, viral and immune disorders are frequently implicated as a cause for this disorder. The following viruses, in particular, have been linked to the subsequent development of Bell’s palsy:

• Herpes simplex
• HIV
• Sarcoidosis
• Herpes zoster virus, which causes chickenpox and shingles
• Epstein-Barr virus

There may also be a genetic inheritance factor toward developing Bell’s palsy, so individuals with a family history of the condition are at a greater risk for its onset.

What are the symptoms of Bell’s palsy?

The facial paralysis characteristic of Bell’s palsy may affect all or only part of the face and may be preceded by the following symptoms:

• Slight fever
• Pain behind the ear on the affected side
• Stiff neck
• Weakness and/or stiffness on one side of the face

These symptoms may begin suddenly and progress rapidly. After the facial paralysis sets in, complications may include:

• Lack of corneal reflex
• Decrease in saliva and/or tear production
• Loss of sense of taste
• Drooling
• Increased sensitivity to sound

In the aftermath of a Bell’s palsy episode, the following may occur during recovery:

• Voluntary muscle movements followed by involuntary contractions of other facial muscles (synkinesia)
• Tears not brought on by emotion (crocodile tears)

How is Bell’s palsy diagnosed?

Usually, a diagnosis of Bell’s palsy can preliminarily be made by a clinical examination with a physician looking at the patient’s face and noticing the difficulty of movement. An electromyography, which is a test used to measure the electrical conductivity of a nerve, can be administered to confirm a diagnosis and evaluate the extent of nerve damage and the severity of the case.

What are the available treatments for Bell’s palsy?

Recovery from Bell’s palsy depends on the extent and severity of damage to the seventh cranial nerve, and fortunately, in most cases of Bell’s palsy, only facial weakness occurs and the paralysis is temporary, resolving in mere weeks. In these cases, treatment is not necessary. However, some cases persist and facial muscles on the affected side are completely paralyzed. This side of the face will become smooth, expressionless, and immobile. In these cases, massage and mild electrical stimulation of the paralyzed muscles can help, as can oral corticosteroid drugs, such as prednisone. In the worst case scenario, surgery can be conducted to connect the peripheral facial nerve with the spinal accessory/hypoglossal nerves.

Where can I find more information on Bell’s palsy?

• National Organization for Rare Disorders (NORD)
• Mayo Clinic
• Healthline
• Facial Paralysis & Bell’s Palsy Foundation