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An increase in knowledge regarding Bell’s palsy could equip people better with the presentation of symptoms of the disease to enable them to take timely steps to seek the required medical intervention and thus ease their recovery.
Although, the exact cause of Bell’s palsy is unknown, several factors contribute to its occurrence
Bell’s palsy is a temporary weakness or paralysis of the facial muscles on one side of the body, usually occurring suddenly. The facial nerve, which is cranial nerve VII, is in charge of the movements of the facial muscles and results from their inflammation or compression. The real cause of Bell’s palsy is still unknown, though viral infections are a major cause, along with immune responses. Dr. Sheetal Goyal, Consultant Neurologist, Wockhardt Hospitals, Mumbai Central shares all you need to know:
This condition affects anyone at any age, though it most frequently occurs between 15 and 60 years of age. Bell’s palsy equally affects males and females; besides being distressing, most patients usually recover completely with time and proper treatment.
Although, the exact cause of Bell’s palsy is unknown, several factors contribute to its occurrence. Viral infections, particularly the herpes simplex virus-1, which causes cold sores. Other viruses include varicella-zoster or chickenpox and shingles virus, Epstein-Barr virus, that is responsible for causing mononucleosis, and cytomegalovirus that leads to inflammation of the facial nerve, causing sudden muscle weakness.
Apart from the viral infections, the response from the immune system also plays an important role. Some people undergo an abnormal immune reaction that can cause inflammation to the facial nerve. People suffering from autoimmune diseases or those undergoing fluctuations in their immune system from infections are generally more susceptible to this condition.
This condition, Bell’s palsy, often affects pregnant women in the third trimester because their hormone levels and fluid retention serve to increase pressure on the facial nerve. This pressure may cause temporary paralysis. Diabetes patients also tend to become predisposed to nerve disorders such as Bell’s palsy since high blood sugar levels disrupt nerve function and make a person more susceptible to infections.
Other factors that can bring about the beginning of Bell’s palsy are lifestyle factors: chronic stress, lack of sleep, and diet. Stress and fatigue can further weaken the immune system, increase the likelihood of viral reactivation, and ultimately lead to inflammation of the nerve.
Bell’s palsy is marked by the acute onset of weakness or paralysis of the face that may be detected on waking. The most common symptoms include the inability to shut one eye on the affected side, drooping of the mouth, which interferes with smiling or speaking, loss of taste sensation on the front two-thirds of the tongue, increased sensitivity to sound (hyperacusis) on the affected side, and excessive tearing or dry eyes due to improper eyelid closure.
These symptoms can be frightening, but it is essential to distinguish Bell’s palsy from serious neurological conditions such as a stroke. Anyone experiencing sudden facial weakness should seek immediate medical attention to rule out other potential causes.
A neurologist usually diagnoses Bell’s palsy based on a clinical examination. In some cases, imaging tests like MRI or CT scans are helpful to rule out other neurological conditions. The condition is temporary in most cases, and recovery usually takes three to six months.
Early treatment better improves recovery outcome, and main treatments are through corticosteroids that suppress inflammation; corticosteroid treatment should commence within 72 hours after developing symptoms. It is advisable to consult a physician and have prescribed antiviral drugs besides using steroids.
Physiotherapy is an important part of rehabilitation. Facial exercises and nerve stimulation therapy is essential to regain muscle strength and prevent long-term weakness. Because Bell’s palsy does not cause muscle stiffness, physiotherapy mainly focuses on the regaining of control over facial movements rather than the reduction of tightness.
Proper management of the care of the patient’s eyes will also be helpful. The abnormal eye is subject to dryness and corneal damage in case it may not blink enough. Lubricating eye drops, protective eyeglasses and sometimes taping the eye at night may provide prevention for serious complications.
Though scaring may be frightening, Bell’s palsy is typically a short-term condition. For most people, complete restoration of facial function will occur with time and, often, with prompt treatment. Some develop mild residual weakness or slight asymmetry of facial movements.
Awareness and seeking medical treatment are basic for its effective management. With proper medication and physiotherapy, most of the patients have no recurrence of this condition. An increase in knowledge regarding Bell’s palsy could equip people better with the presentation of symptoms of the disease to enable them to take timely steps to seek the required medical intervention and thus ease their recovery.
