Bell’s Palsy

What Is Bell’s Palsy or Facial Palsy?

Bell’s palsy or facial palsy is an unexplained condition, causing weakening and paralysis of the facial muscles. Usually, a compressed or pinched facial nerve leads to paralysis. People with this condition may have a floppy appearance on one or both sides of the face. The inflammation of the seventh cranial nerve that regulates the facial muscles, makes the face on one side appear droopy.

People with this condition may also have eyelids remaining open or asymmetrical smiles. The condition may last for several months and often goes away without treatment. Typically, men and women between fifteen and sixty years of age are prone to this condition. Permanent recovery from the condition may take about two weeks to six months from the appearance of symptoms, and only in rare cases, it stays for a lifetime.

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Bell’s palsy or facial palsy is an unexplained condition, causing weakening and paralysis of the facial muscles. Usually, a compressed or pinched facial nerve leads to paralysis.

Symptoms of Bell’s Palsy or Facial Palsy:

The symptoms of this condition appear suddenly and may reach the peak within forty-eight to seventy-two hours. While in some people, the symptoms are mild, others may experience complete paralysis. The symptoms may start showing improvement within two to three weeks, and about eighty percent of people recover fully within three months. The symptoms of the condition are:

  • Drooling
  • Facial weakness
  • Losing the ability to show facial expressions like frowning and smiling
  • Twitched muscle on the face
  • Difficulty in eating and drinking
  • Dryness in the eyes and mouth
  • Sensitivity to sound and headache
  • Irritation on the eye of the affected side
  • Loss of taste on the front part of the tongue
  • the eye on the affected side stays open
  • Tinnitus or ringing in the ears

The symptoms of this condition may have similarities with other medical problems, so it is best to discuss with a doctor.

Causes of Bell’s Palsy or Facial Palsy:

The exact cause of Bell’s palsy or facial palsy is not known, but a viral infection may trigger the problem. The estimated causes of this condition are:

  • Hypertension
  • Diabetes
  • Herpes Simplex virus causing genital herpes and cold sores
  • Epstein – Barr virus causing mononucleosis
  • Sarcoidosis causing inflammation orf organs
  • Herpes zoster virus causing  shingles and chickenpox
  • HIV damaging the immune system
  • Myasthenia gravis
  • Lyme disease
  • Multiple sclerosis
  • Toxins
  • Injury
  • Neurofibromatosis
  • Ramsay Hunt Syndrome
  • During the surgical removal of facial nerve tumor or acoustic neuroma
  • Cytomegalovirus infections
  • Respiratory diseases through adenovirus
  • German measles or rubella
  • Flu
  • Hand-foot-and –mouth disease
  • Mumps

The viral infection causes the facial nerve to become inflamed or swollen, causing this condition.

When to See a Physiotherapist for Bell’s Palsy or Facial Palsy?

A scheduled visit to the physical therapist’s clinic is useful during the first couple of days from when the symptoms show. The therapist reviews the person’s medical history and finds out about the underlying conditions and previous surgeries. They also evaluate the present symptoms and the things that may improve or worsen them. The therapist:

  • Educates the person about how to protect the eye and face
  • Shows ways to manage daily life with facial paralysis
  • Explain the way to recovery after assessing the symptoms

Exercises and therapy restore muscle strength and help regain facial coordination faster. The exercises must be done about three to four times a day, with about twenty to thirty repetitions for each exercise. The exercises are:

  • Facial stimulation
  • Nose and cheek exercises to remove the stiffness from these areas
  • Mouth exercises to promote ease of eating and drinking ad regain better control of the mouth
  • Eye exercises to aid the muscle movement around the eyes

All the exercises for this condition can be practiced at home safely and without supervision. However, overexertion of the muscles needs to be avoided. In case of muscle pulling during exercises, it is essential to allow them to relax.

Risks of Bell’s Palsy or Facial Palsy:

Mild symptoms of the condition disappear without treatment, although the recovery time may differ. The complications are:

  • Excessive damage to the facial nerve
  • Partial or complete blindness when the eye does not close due to dryness and the removal of the protective covering or cornea
  • Regrowth of the nerve fibers may be abnormal, and the eye on the affected side may close during smiling.

How to Prevent Bell’s Palsy or Facial Palsy?

The condition cannot be prevented or avoided, so the affected person must call the doctor when symptoms appear.

Treatments of Bell’s Palsy or Facial Palsy:

The condition may improve without treatment but the healthcare provider may recommend the following treatments.

  • Oral corticosteroids to reduce nerve swelling within 48hours of the symptom
  • Antiviral medicines for recovery from herpes but work better when combined with Oral corticosteroids.
  • Decompression surgery to ease pressure on the nerve but rarely performed as it may cause hearing loss
  • Facial plastic surgery procedures are for those who do not recover. It helps in correcting facial asymmetry and eyelid closure.
  • Using eye drops
  • Applying eye patch for dry eyes and wrapping a warm and moist towel over the face to relieve pain
  • Physical therapy exercises stimulate the facial muscles

Related Conditions:

The related conditions are all associated with viral diseases, so treating the symptoms of the viral infections can help. Most people recover from the symptoms unless the cause is more serious such as nerve damage due to cerebral stroke.

Frequently Asked Questions

1. Is Bell’s palsy or facial palsy a permanent condition?
It is not permanent except in rare cases. There is no definite solution to cure this disorder but most people recover through treatment options.
2. Is the condition fatal?
It is not a fatal condition but may produce symptoms similar to other causes of facial paralysis such as stroke or tumor.

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