Bell's Palsy: Causes, Signs, Symptoms, Treatment, Diagnosis
What is Bell's Palsy?
Development of weakness or paralysis of the facial muscles on one side of the face is known as Bell's palsy . This occurs due to damage or injury to the facial nerve, which controls the muscles on one side of the face resulting in drooping of the affected side of the face. The damage to the facial nerve can also affect patient's sense of taste and the production of saliva and tears. Bell's palsy develops suddenly (usually overnight) and often gets better on its own in a few weeks.
Transient ischemic attack (TIA) or stroke cannot result in Bell's palsy. However, facial paralysis can occur due to stroke and TIA , but there is no association between either of these conditions and Bell's palsy. If the patient has developed sudden weakness on one side of the face, then it is important that it is checked by the doctor immediately to exclude more serious causes.
Causes of Bell's Palsy
Unknown Cause:The exact cause of Bell's palsy is not known.
Herpes Virus: In most of the patients, it is thought to occur from herpes virus that is responsible for cold sores.
Facial Nerve Damage: In majority of cases of Bell's palsy, the facial nerve responsible for controlling the muscles on one side of the face gets damaged from inflammation.
Other Medical Problems: Other than this, there are various health problems, which can cause paralysis or weakness of the face. If an exact cause cannot be found, then the condition is referred to as Bell's palsy.
Signs & Symptoms of Bell's Palsy
- Patient has development of paralysis or sudden weakness on one side of the face resulting in drooping of that affected facial side. This is the primary symptom of Bell's palsy.
- Patient finds it difficult to close the eye on the affected side of the face.
- Bell's Palsy Patient is likely to have symptoms of drooling.
- Loss of ability to taste is also one of the symptoms of Bell's Palsy.
- Numbness is felt on the affected side of the face.
- Patient suffering from Bell's Palsy experiences other eye problems, such as dry eye or excessive tearing of the eye.
- Pain is felt in the ear or behind the ear.
- There is increased sensitivity to sound.
Diagnosis of Bell's Palsy
The doctor conducts a physical exam and asks multiple questions to the patient to diagnose Bell's palsy, which includes the timing and the method of development of symptoms. Neurological exam is conducted to check the function of the facial nerve. To further diagnose the cause of the symptoms, various tests are done which include blood tests, CT scan and MRI scan.
Treatment of Bell's Palsy
No treatment: Most of the patients suffering from Bell's palsy have complete recovery within a month or two and without any treatment. This holds more true for patients who still have partial movement in their facial muscles. However, there is a small minority of patients who can have permanent muscle weakness or other problems related to the affected side of the face.
Medications: Treatment for Bell's palsy consists of medications, such as corticosteroids (prednisone), which helps the patient in regaining complete facial movement. Corticosteroids acts best if they are taken immediately after the development of the symptoms, i.e. within a couple of days. Antiviral medicines (acyclovir) can also be added to corticosteroid medicines for treating Bell's palsy in some cases. However, there is no strong evidence of benefit of antiviral medicine use in Bell's palsy. They can help in some patients, but overall they do not affect the recovery of the patient. In some cases, patients may have other health issues due to which they are not able to take corticosteroid medicines. However, like mentioned before, most of the patients suffering from Bell's palsy recover completely without having any treatment.
Facial Exercises for Bell's Palsy: Patient can do facial exercises at home, which include tightening and relaxing of the muscles of the face. These exercises help in strengthening the facial muscles and speeding up the recovery process of Bells Palsy.
Massage to Get Relief from Bell's Palsy: Massage can be done of the cheeks, forehead and lips using a cream or oil for added benefit.
Caring for the Mouth: If the patient has no feeling and very little saliva on one side of the tongue, then it causes food to get stuck in that place resulting in tooth decay or gum disease. It is important to floss and brush your teeth multiple times to prevent these problems. To prevent problems with swallowing, Bell's Palsy patient needs to eat slowly and chew the food slowly and well. It is also recommended to eat smooth and soft foods, such as mashed rice and yogurt.
Caring for the Eye: If the patient is not able to close or blink the eye on the affected side completely, it can lead to dryness of the eye, which in turn can cause sores and problems with the vision. To avoid these problems and to keep the eye moist and to protect it, patient must do the following:
- Use his/her finger to close and open the eyelid multiple times throughout the day.
- Using ointment or eye drops ("artificial tears"). Drops can be used during the day and ointment can be used during the night before sleeping.
- It is recommended to wear an eye patch when sleeping, and wear goggles/glasses during the remaining time.