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What Is Bell's Palsy? Causes, Symptoms, Complications And Treatment

Bell's palsy is a condition which causes temporary weakness or paralysis of facial muscles. This condition may occur if the nerve that controls your facial muscles becomes inflamed, swollen, or compressed. The condition is named after the Scottish anatomist Charles Bell, who was the first to describe it.

What Is Bell's Palsy?

Bell's palsy is also referred to as 'acute facial palsy of unknown cause.' It's a condition in which the muscles on one side of your face become weak or paralyzed. The condition only affects one side of the face at a time, causing it to droop or become stiff [1].

You may have difficulty smiling or closing your eyes on the affected side. Generally, Bell's palsy is a temporary condition, and the symptoms usually disappear within a few weeks or months.

A person can develop Bell's palsy at any age, but it is more common in people between the ages of 16 and 60.

What Causes Bell's Palsy?

A Bell's palsy occurs when the 7th cranial nerve becomes swollen or compressed, causing weakness or paralysis of the face. The exact cause of this nerve damage is unknown, but many medical professionals believe it is caused by a viral infection [2].

Although the exact cause of Bell's palsy is unknown, it is often associated with viral infections. A number of viruses have been associated with Bell's palsy, including the following:

  • Cold sores and genital herpes (herpes simplex)
  • Flu (influenza B)
  • Hand-foot-and-mouth disease (coxsackievirus)
  • Mumps (mumps virus)
  • Infectious mononucleosis (Epstein-Barr)
  • Cytomegalovirus infections
  • Respiratory illnesses (adenovirus)
  • German measles (rubella)
  • Chickenpox and shingles (herpes zoster)

Several experts believe that something may wake up a dormant viral infection, causing Bell's palsy. The following triggers have been identified [3]:

  • Stress
  • Recent physical trauma
  • Autoimmune condition
  • Sleep deprivation
  • Genetics (some people might even have an inherited predisposition to developing Bell's palsy)

What Are The Symptoms Of Bell's Palsy?

An individual with Bell's palsy has droopy facial features and is unable to open or close the eye on the affected side. Bell's palsy can affect both sides of your face in rare instances.

Bell's palsy symptoms may range from mild weakness to total paralysis. Generally, the more inflammation and compression the facial nerve suffers, the more severe the paralysis becomes and the longer it takes for the nerve to heal and regain function [4].

Symptoms usually develop abruptly, and you may notice them when you wake up in the morning or when you eat or drink. Bell's palsy usually develops one to two weeks after you have [5]:

  • Cold
  • Ear infection
  • Eye infection

Other signs and symptoms of Bell's palsy include:

  • Facial weakness
  • A droopy mouth
  • Drooling
  • A lack of ability to make facial expressions, such as smiling or frowning
  • Difficulty pronouncing certain words
  • Dry eye and mouth
  • Altered taste
  • Sensitivity to sound
  • Difficulty eating and drinking
  • Muscle cramps in the face
  • Irritation of the eye on the involved side
  • Headache

What Are The Risk Factors For Bell's Palsy?

Bell's palsy is more likely to develop in individuals who belong to one of the following groups [6]:

  • Pregnant women
  • People with diabetes
  • People who are obese
  • Have a lung infection
  • Have a family history of the condition

What Are The Complications Of Bell's Palsy?

Mild cases of Bell's palsy usually disappear within a month. However, the recovery process may differ in a more severe case where the face was completely paralyzed. Complications may include the following [7]:

  • Permanent nerve damage to the face
  • An irregular regrowth of nerve fibres
  • Partial or complete blindness of the eye that won't close

How Is Bell's Palsy Diagnosed?

There's no specific test for Bell's palsy. Instead, your health care provider will look at your face and ask you to move your facial muscles by closing your eyes, lifting your brow, showing your teeth and frowning, among other movements.

Other conditions such as a stroke, infections, Lyme disease, inflammatory conditions and tumours can cause facial muscle weakness that mimics Bell's palsy. If the cause of your symptoms isn't clear, your health care provider may recommend other tests, such as the following [8]:

  • Electromyography (EMG)
  • Imaging scans
  • Blood tests

How Is Bell's Palsy Treated?

For the most part, Bell's palsy symptoms improve without treatment. Nevertheless, it may take several weeks or months for your face's muscles to regain their normal strength [9].

Here are a few treatments that may assist in your recovery. Your physician may prescribe the following medications:

  • Corticosteroids, which reduce inflammation
  • You may be prescribed antiviral or antibacterial medication if a virus or bacteria is the cause of your bell's palsy
  • Ibuprofen or acetaminophen (over-the-counter pain medications) for relieving mild pain
  • Eye drops to keep your affected eye well lubricated

Home treatment

  • An eye patch (for dry eye)
  • A warm, moist towel over your face to relieve pain
  • Facial massage [10]
  • Physical therapy exercises to stimulate your facial muscles

On A Final Note...

Surgery is not recommended as a first treatment option for Bell's palsy. However, it may be necessary if your symptoms do not improve or complications occur.

[image source: freepik]

Story first published: Tuesday, June 14, 2022, 9:38 [IST]
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