Nervous System
Bell's Palsy
​​Overview:
  • Loss of ability to move face, as facial muscles appear to droop or weaken. 
  • It can occur when the nerve that controls your facial muscles becomes inflamed, swollen, or compressed.
  • Early treatment that starts once the symptoms appear may lead to higher chances of a full recovery. 
  • Using lubricating eye drops and wearing protective eyeglasses can protect your eyes from complications.

What is Bell’s palsy?
Bell’s palsy refers to the loss of ability to move face, as facial muscles appear to droop or weaken. This paralysis can happen on one or both sides of your face. It can also happen suddenly or gradually over several months, depending on the cause. It's believed to be the result of swelling and inflammation of the nerve that controls the muscles on one side of your face. Or it might be a reaction that occurs after a viral infection. The paralysis may persist for a short or long period of time, but recurrent attacks are rare.
 
Other names:
Seventh cranial nerve inflammation, facial nerve palsy, or facial paralysis. 

Cause:
Bell’s palsy occurs when the nerve controlling the muscles of your face becomes inflamed, swollen or compressed, resulting in facial weakness or paralysis. The exact cause of this damage is unknown.

Risk factors:
  • Family history.
  • Infection or inflammation of the facial nerve.
  • Bacterial infections, such as: Lyme disease or Typhoid fever.
  • Syphilis, tuberculosis, and frequent middle ear infections.
  • Neurological disorders, such as: Guillain-Barré syndrome, multiple sclerosis, and mucopolysaccharidosis.
  • Head injuries, such as: Skull fracture or facial injury.
  • Stroke.
  • Tumors that compress the facial nerve.
  • Viruses, such as: Flu, colds, or infectious white blood cells.

Symptoms:
  • Inability to raise eyebrow.
  • Inability to close eyelids and protect eyeballs from dryness. 
  • Drooping of the lower eyelids, which increases tear flow. 
  • Inability to control lip movement, which leads to slower speech.
  • Impaired sense of taste. 
  • Difficulty eating or drinking. 
  • Drooling.

When to see a doctor?
When a facial weakness or drooping is noticed, to determine the cause and severity of the disease.

Complications:
  • Facial nerve damage.  
  • Permanent weakness of facial muscles.
  • Involuntary muscle contractions. 
  • Partial or complete blindness of the eye that cannot close due to excessive dryness and scratching of the cornea.

Diagnosis:
Diagnosing Bell's palsy is often complex, as it may be caused by a disorder within a part of the brain called the motor cortex, an injury to the facial nerve, or a damage of the muscles that control facial expressions. The diagnosis includes consulting a doctor, a complete physical examination, and brain and face imaging. The doctor may also recommend one or more of the following imaging tests:
  • MRI scans.
  • CT scans.
  • Electromyogram.

Treatment:
Early treatment of symptoms may increase the chance of a full recovery, as treatment usually includes steroid pills, such as: Prednisone and antivirals, in addition to:
  • Botox injections.
  • Physical therapy sessions.

Guidelines for People with Bell's Palsy:
Avoiding dryness of the affected eye by applying artificial tears (moisturizing eye drops) throughout the day and ointments at night. An individual with Bell’s palsy may also need to wear an eye patch at night and protective glasses during the day. This aims to protect the affected eye from complications.

FAQ:
  • Can a change in the air current lead to Bell's palsy?
    • Studies have not proven that exposure to a cold is a risk factor for developing Bell’s palsy. This is because Bell’s palsy is a neurological disorder that may be related to viral infections. However, the role that this virus plays in the disease is unclear.

Clinical Education General Department
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