What Causes BELL'S PALSY - Bell’s Palsy Explained - Symptoms - Cause - Complications - Treatment
What Causes BELL'S PALSY - Bell’s Palsy Explained - Symptoms - Cause - Complications - Treatment
Bell's palsy causes sudden weakness in your facial muscles. This makes half of your face appear to droop. Your smile is one-sided, and your eye on that side resists closing.
Bell's palsy, also known as facial palsy, can occur at any age. The exact cause is unknown, but it's believed to be the result of swelling and inflammation of the nerve that controls the muscles on one side of your face. It may be a reaction that occurs after a viral infection.
For most people, Bell's palsy is temporary. Symptoms usually start to improve within a few weeks, with complete recovery in about six months. A small number of people continue to have some Bell's palsy symptoms for life. Rarely, Bell's palsy can recur.
SYMPTOMS
Signs and symptoms of Bell's palsy come on suddenly and may include:
.Rapid onset of mild weakness to total paralysis on one side of your face — occurring within hours to days
.Facial droop and difficulty making facial expressions, such as closing your eye or smiling
.Drooling
.Pain around the jaw or in or behind your ear on the affected side
CAUSES
Although the exact reason Bell's palsy occurs isn't clear, it's often linked to exposure to a viral infection. Viruses that have been linked to Bell's palsy include the virus that causes:
. Cold sores and Genital herpes (herpes simplex)
. Chickenpox and Shingles (Herpes zoster)
. Mononucleosis (Epstein-Barr)
. Cytomegalovirus infections
. Respiratory illnesses (adenovirus)
. German Measles (Rubella)
. Mumps (Mumps virus)
. Flu (Influenza B)
. Hand-foot-and-mouth disease (coxsackievirus)
. Increased sensitivity to sound on the affected side
. Headache
. A decrease in your ability to taste
. Changes in the amount of tears and saliva you produce
RISK FACTORS
Bell's palsy occurs more often in people who:
Are pregnant, especially during the third trimester, or who are in the first week after giving birth
Have an upper respiratory infection, such as the Flu or a cold
Have Diabetes
Also, some people who have recurrent attacks of Bell's palsy, which are rare, have a family history of recurrent attacks. In those cases, there may be a genetic predisposition to Bell's palsy.
COMPLICATIONS
A mild case of Bell's palsy normally disappears within a month, but recovery from a more severe case involving total paralysis varies. Complications may include:
Irreversible damage to your facial nerve
Misdirected regrowth of nerve fibers, resulting in involuntary contraction of certain muscles when you're trying to move others (synkinesis) — for example, when you smile, the eye on the affected side may close
Partial or complete blindness of the eye that won't close due to excessive dryness and scratching of the cornea, the clear protective covering of the eye
TESTS AND DIAGNOSIS
There's no specific test for Bell's palsy. Your doctor will look at your face and ask you to move your facial muscles by closing your eyes, lifting your brow, showing your teeth and frowning, among other movements.
Other conditions — such as a Stroke, infections, Lyme disease and Tumors — can also cause facial muscle weakness, mimicking Bell's palsy. If it's not clear why you're having the symptoms you are, your doctor may recommend other tests, including:
Electromyography (EMG). This test can confirm the presence of nerve damage and determine its severity. An EMG measures the electrical activity of a muscle in response to stimulation and the nature and speed of the conduction of electrical impulses along a nerve.
Imaging scans. Magnetic resonance imaging (MRI) or computerized tomography (CT) may be needed on occasion to rule out other possible sources of pressure on the facial nerve, such as a Tumor or skull fracture.
TREATMENTS AND DRUGS
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 also unlikely to be beneficial.
However, despite this, valacyclovir (Valtrex) is sometimes given in combination with prednisone in people with severe facial palsy.