Bell's palsy is a paralysis or weakness of the muscles on one side of the face. This condition afflicts around one in every 2000 people every year, with young adults of either sex more susceptible for unknown reasons. Bell's palsy is characterised by a droopy appearance around the eye and mouth on the affected side of the face. It is caused by the swelling of the facial nerve at the point where it passes through a small opening in the skull. The pinched and swollen nerve becomes inflamed, which interferes with the nerve's proper functioning. The reason for the swelling is unknown, although infection or autoimmune responses are suspected. Bell's palsy usually resolves by itself within a few months. Treatment options to alleviate some of the symptoms may include medications such as corticosteroids. A person has a less than one in 10 chance of experiencing a subsequent bout of Bell's palsy.
Symptoms
The symptoms of Bell's palsy include:
- Paralysis or weakness on one side of the face
- Numbness
- Pain around the ear
- The eye can't fully close
- The mouth droops
- The face feels heavy
- Foods taste slightly different.
High risk individuals
The majority of people with Bell's palsy, around 90 per cent, will recover completely with time. However, the remaining 10 per cent will experience some degree of permanent paralysis. Older people with pre-existing high blood pressure are at greater risk of this complication.
Facial nerve
The facial nerve services the muscles of the face, the ear, salivary and tear glands and provides some of the sensations of taste on the tongue. This nerve enters the skull via a small opening in the petrous temporal bone at the base of the skull. In Bell's palsy, the facial nerve swells and the resulting inflammation disrupts the relay of nervous system messages. The paralysis can be partial or total. It is thought that the inflammation and swelling of the facial nerve is caused by some type of viral infection or autoimmune system response.
Diagnosis methods
A variety of other conditions can cause facial paralysis including trauma, stroke, certain tumours and infections. It is important to rule out these other potential causes. Bell's palsy is diagnosed in a number of different ways, including clinical examination. The patient is typically asked to raise their eyebrows, close their eyes and smile. If the person has Bell's palsy, their eyebrows will raise asymmetrically, they won't be able to close the affected eye and one side of the mouth will droop. Special scans, including CT and MRI scans, may also be used to exclude other causes. .
Treatment options
Bell's palsy usually resolves by itself with time, although the paralysis may last for up to one year in severe cases. Treatment options can include:
- Artificial tears to keep the affected eye lubricated
- A patch to protect the affected eye
- Using tape to close the affected eyelid at night
- Medications including corticosteroids to help reduce the swelling of the facial nerve
- Painkillers
- Massage
- Facial exercises
- Surgery, although this is an unusual form of treatment and rarely effective.
Where to get help
Things to remember
- Bell's palsy is a paralysis or weakness of the muscles on one side of the face.
- The cause is unknown, although infection or autoimmune responses are suspected.
- The majority of people with Bell's palsy, around 90 per cent, will recover completely with time.
You might also be interested in:
Guillain-Barre syndrome.
Nervous system.
Neuromuscular system.
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