Determining whether facial nerve paralysis is peripheral or central is a key step in the diagnosis(1).
The facial nerve also carries nerve impulses to the tear glands, the saliva glands, and the muscles of a small bone in the middle of the ear(2).
Who Is At Risk For Bell’s Palsy?
Almost all the people of any age group can be affected by the bell’s palsy even without prior history or risk factors. But even then, there are few of the risk factors that have been connected to this condition by widespread research and epidemiological data.
Firstly, all the cases suffering from diabetes are known to be prone to get this condition. It is perhaps because diabetes can cause widespread nerve damage in any of the nervous tissue belonging to the central or peripheral nervous system. The facial nerve can also get affected by diabetes and can result in this condition.
Another common risk factor responsible for this condition is the presence of upper respiratory tract infection such as a common cold or flu. It is because these upper respiratory tract infections are related to various influenza viruses which are an important risk factor to get migrated to nervous tissue.
Another factor that has been identified to be linked with facial palsy in pregnancy. According to a study conducted on pregnant women in the United States, it has been found that the pregnant women in their third trimester or first week of the postpartum period are more likely to suffer from bell’s palsy rather than during the whole pregnancy. The cause and the mechanism responsible for this risk is not known(3).
Is There A Blood Test For Bell’s Palsy?
There is no specific test available for diagnosis of Bell’s palsy. A variety of blood tests can be ordered to rule out the risk factors and causes but none of the blood tests is a specific or sensitive marker for bell’s palsy. Although to rule out risk factors, various blood tests such as blood glucose, Hba1c, titers for borrelia burgdorferi, herpes simplex virus, mycoplasma pneumonia, antineutrophil cytoplasmic antibodies, etc. can be done.
The diagnosis is based on the history of the patient and the clinical examination done by a specialist physician. Symptoms of this condition can be noted and the person is examined for the presence of the signs such as the absence of closure of one eyelid, deviation of the mouth, absence of nasolabial fold, inability to produce stress lines on the forehead, blowing of air in the mouth, inability to clench the teeth properly, etc. These all signs if present along with the relevant history without any other possibility confirms the diagnosis of Bell’s palsy.
To confirm this diagnosis, electromyography can be done to find out the damage that has been incurred by the facial nerve. It can measure the electrical impulse passing through the nerve and response to it. Other imaging studies such as magnetic resonance imaging and computed tomography can also be done to rule out other causes of facial deviation such as tumors, stroke, etc.
After the widespread research in this field, there have been numerous risk factors that have been identified as the causes of facial muscle paralysis. These risk factors can be found and eliminated by medical treatment so that the chances of getting this condition are reduced.
Since it is not an infective condition, there is no specific blood test available for the confirmatory diagnosis. Relevant blood tests can be done to find out the cause and it may also change the dynamics of the case. Additional antibiotic or antiviral treatment can be started along with steroid therapy.
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