It is a condition that causes temporary weakness or paralysis of the muscles in the face. It can occur when the nerve that controls your facial muscles becomes inflamed, swollen, or compressed. The condition causes one side of your face to droop or becomes stiff. You may have difficulty smiling or closing your eye on the affected side. In most cases, Bell’s palsy is temporary and symptoms usually go away after a few weeks. Although Bell’s palsy can occur at any age, the condition is more common among people between ages 16 and 60. Bell’s palsy is named after the Scottish anatomist Charles Bell, who was the first to describe the condition.
Cause:
Bell’s palsy occurs when the seventh cranial nerve becomes swollen or compressed, resulting in facial weakness or paralysis. The exact cause of this damage is unknown, but many medical researchers believe it’s most likely triggered by a viral infection. The viruses/bacteria that have been linked to the development of Bell’s palsy include:-
1. Herpes simplex, which causes cold sores and genital herpes.
2. HIV, which damages the immune system.
3. Sarcoidosis, which causes organ inflammation.
4. Herpes zoster virus, which causes chickenpox and shingles.
5. Epstein-Barr virus, which causes mononucleosis.
6. Lyme disease, which is a bacterial infection caused by infected ticks.
Symptoms:
Signs and symptoms of Bell's palsy come on suddenly and may include:-
1. Rapid onset of mild weakness to total paralysis on one side of your face — occurring within hours to days.
2. Facial droop and difficulty making facial expressions, such as closing your eye or smiling.
3. Drooling.
4. Pain around the jaw or in or behind your ear on the affected side.
5. Increased sensitivity to sound on the affected side. By
6. A headache.
7. A decrease in your ability to taste.
8. Changes in the number of tears and saliva you produce.
Diagnosis:
Your doctor will first perform a physical examination to determine the extent of the weakness in your facial muscles. They’ll also ask you questions about your symptoms, including when they occurred or when you first noticed them. Your doctor can also use a variety of tests to make a Bell’s palsy diagnosis. These tests may include blood tests to check for the presence of a bacterial or viral infection. Your doctor might also use an MRI or CT scan to check the nerves in your face.
Treatment:
Most people with Bell's palsy recover fully — with or without treatment. There's no one-size-fits-all treatment for Bell's palsy, but your doctor may suggest medications or physical therapy to help speed your recovery. Surgery is rarely an option for Bell's palsy.
Medications:
Commonly used medications to treat Bell's palsy include:-
- Corticosteroids, such as prednisone, are powerful anti-inflammatory agents. If they can reduce the swelling of the facial nerve, it will fit more comfortably within the bony corridor that surrounds it. Corticosteroids may work best if they're started within several days of when your symptoms started.
- Antiviral drugs: The role of antivirals remains unsettled. Antivirals alone have shown no benefit compared with placebo. Antivirals added to steroids are possibly beneficial for some people with Bell's palsy, but this is still unproven. However, despite this, valacyclovir (Valtrex) is sometimes given in combination with prednisone in people with severe facial palsy.
Home treatment:
- An eye patch (for your dry eye).
- A warm, moist towel over your face to relieve pain.
Physical therapy:
Paralyzed muscles can shrink and shorten, causing permanent contractures. A physical therapist can teach you how to massage and exercise your facial muscles to help prevent this from occurring.
Exercise:
Doing any exercises, you should perform simple facial massages:
1. Using your fingers, massage and gently stretch the skin from the corner of your mouth toward the ear and then down to the jaw bone in a circular pattern.
2. Do the same circular pattern on your chin and forehead.
3. With your finger (or electric toothbrush/make-up brush/ice cube), brush [the] forehead in an upward direction toward the hairline, two to three times. Do the same with the cheek area, or try gentle tapping on the skin with your fingertips.
Basic movements:
You will be taught specific exercises such as the forehead wrinkle, eye closure, smiling, snarling and lip pucker. These will be done at varying speeds and intensity.
• Jaw movements: Relaxing the lower jaw, exercises of the mouth and eye movements will be performed.
• Lip closure exercises: These involve filling the cheeks with differing amounts of air, along with eating and drinking exercises while keeping the eye open.
• Expression exercises:
1. You will be guided to use your muscles to recreate common facial expressions, such as anger and astonishment. Sniffle, wrinkle nose and flared nostrils.
2. Curl your upper lip up, and then raise and protrude the upper lip.
3. Try to smile without showing teeth, then smile showing teeth.
4. Using your index finger and thumb, pull the corners of your lips in toward the centre. Slowly and smoothly push out and up into a smile. Continue the movement up to the cheekbone. Use firm pressure.
5. Try to close the eye slowly and gently, without letting your mouth pull up or your eyebrow moves downward.
6. Try to raise your eyebrows, and then hold for 10 to 15 seconds. Pause and repeat.
7. Gently wink with one eye, and then try the other one. Do it to the best of your ability, and do not push it.
8. Open eyes widely, but without involving your eyebrow.
Risk factors:
Your risk of developing Bell’s palsy increases if you:
1. Are pregnant.
2. Have diabetes.
3. Have a lung infection.
4. Have a family history of the condition.
Complications:
1. You may have damage to the seventh cranial nerve. This nerve controls your facial muscles.
2. You may have excessive dryness in the eye, which can lead to eye infections, ulcers, or even blindness.
3. You may have synkinesis, which is a condition in which moving one body part causes another to move involuntarily. For example, your eye may close when you smile.