Bell's Palsy

Overview

Bell's Palsy also known as 'acute facial palsy' is a type of condition where the muscles in your face become paralyzed or weak. It typically only affects one side of a person’s face, which can make it suddenly appear stiff. Most often, the weakness tends to be short-term and can improve over the course of a few weeks. This can also have other effects, making it hard to close your eye on the affected side. Although the causes are currently unknown, it’s believed to result from trauma to the seventh cranial nerve, responsible for controlling your facial expressions.

What is Bell's Palsy?
Bell palsy is a sudden, unexplained episode of facial muscle weakness or paralysis that can worsen within 48 hours. This condition is caused by damage to the facial nerve (the 7th cranial nerve), leading to pain and discomfort typically on one side of the face or head. Symptoms may include an inability to close the eyelid properly and an uneven smile. Bell's palsy usually affects adults and is more common in individuals with diabetes, those who are pregnant, or those with a family history of the condition.

Bell palsy is typically not permanent, although in rare cases, it may persist. There is currently no known cure for Bell palsy, but recovery generally begins within 2 weeks to 6 months from the onset of symptoms. Most individuals regain full facial strength and expression. Treatment with steroids can aid recovery, with most people improving within 6 months.

Symptoms of Bell's Palsy

The symptoms of Bell’s palsy can be quite sudden and is signified by paralysis in the face. The severity of the symptoms can range from mild weakness to complete paralysis, however, it’s primarily on one side of the face.

According to the NHS, the symptoms of Bell's palsy include:

weakness on 1 side of your face, or not being able to move 1 side of your face – this usually happens over a few days
a drooping eyelid or corner of your mouth
drooling
a dry mouth
loss of taste
a dry or watering eye
If you experience symptoms on both sides of your face, it may indicate a condition other than Bell's palsy.

Causes of Bell's Palsy

The exact cause of Bell's palsy is unknown, but it is believed to result from inflammation directed by the body's immune system against the nerve controlling facial movement. According to healthcare experts, Bell palsy may be associated with several issues, including diabetes, high blood pressure, toxins, Lyme disease, Guillain-Barré syndrome, sarcoidosis, and viral infections like Herpes simplex virus (the virus responsible for cold sores). Other contributing factors might involve problems with the immune system, reduced blood flow to the facial nerve (the 7th cranial nerve), or viral infections causing swelling of the facial nerves.

Other triggers for Bell's palsy may include having a weakened immune system due to stress, illnesses, sleep deprivation, physical trauma, or autoimmune conditions.

Tests and Treatments for Bell's Palsy

The primary physical exam finding for Bell's palsy is partial or complete weakness of the forehead. However, your healthcare provider may recommend additional tests, including:

- Blood tests to check for conditions like Lyme disease or sarcoidosis.
- Electromyography (EMG) to measure nerve activity and damage, which can help predict recovery time.
- Magnetic resonance imaging (MRI) or computed tomography (CT) scans to rule out stroke, tumor, multiple sclerosis, or other causes of nerve damage.
- Lumbar puncture (spinal tap) to check for meningitis, Lyme disease, or sarcoidosis.

Symptoms of Bell's palsy should nearly resolve in about 2 to 3 months. However, some residual effects, such as mild facial paralysis or reduced movement on one side of the face, may persist. There is no specific treatment for Bell’s palsy, and it typically improves on its own within a few weeks. An ophthalmologist can help manage eye-related symptoms by prescribing eye drops or other lubricants to provide relief if you cannot fully close your eye.

Prevention for Bell's Palsy

There's no way to one can prevent Bell's palsy. If you have risk factors such as diabetes, obesity, or high blood pressure, managing these conditions effectively may help lower your risk.

While it's associated with certain viral infections, not everyone who contracts these infections will develop Bell's palsy.