Bell’s palsy

Bells palsy patient

Last Updated December 20th, 2021

Overview of Bell’s palsy

Neurological disorders arise from problems of the central and the peripheral nervous system. Brain damage or brain injury can also lead to these conditions. These disorders may be congenital or may develop at a later stage. Bell’s palsy is one such disorder that mainly affects the facial muscles. It is characterized by a number of sensory disorders and is easily identifiable. The incidence rate of the disease is about 1 to 4 per 10,000 people each year.

 

What is Bell’s palsy?

Bells Palsy manBell’s palsy is a form of facial nerve paralysis that leads to involuntary movements of the facial muscles. The disease is named after Charles Bell, the doctor who first described the condition. It is usually unilateral in nature, that is, it affects the muscles on any one side of the face. The patients may exhibit muscle twitching, drooping of the eyelids and photosensitivity. The condition is more prevalent in people aged 15-45. However, there are instances where the disease has been seen in infants and aged people as well. Abnormal functioning of the cranial nerve is believed to be responsible for the disease. Other conditions associated with the disease are stroke, brain tumor, and Lyme disease. Bell’s palsy is responsible for 70% of the cases of one-sided facial nerve paralysis.

 

What are the main causes of Bell’s palsy?

In many cases, Bell’s palsy is idiopathic in nature. But in most of the cases, the following factors are identified-

  • Dysfunctions of the cranial nerve VII (facial nerve)
  • Upper respiratory tract infection
  • Metabolic diseases like Diabetes
  • Viral infections (cause swelling)
  • A history of a brain tumor, stroke, Lyme disease or Ramsay Hunt syndrome

 

How does Bell’s palsy occur?

Bells palsy patientThe pathophysiology of Bell’s palsy is quite complex. It mainly arises due to dysfunctions of the facial nerve (VII cranial nerve) that regulates the facial muscles. The paralysis, in this case, is of intranuclear or lower motor neuron type.

Studies have traced the origin of this paralysis to an inflammation of the facial nerve. Pressure is exerted on the nerve at the point of exit from the skull within the bony canal. This inhibits the transmission of neural signals and results in damage to the nerves. In certain cases of a bilateral facial palsy, acute HIV infection has been found to be responsible.

In some other cases, the Herpes Simplex Virus (HSV-1) has been found to be associated with demyelination of nerves. This results in edema, swelling, and compression of the nerve in the narrow bone canal. This is often seen as an unknown immune system response.

 

What are the main signs and symptoms of Bell’s palsy?

Bell’s palsy is mainly characterised by paralysis of the muscles on one side of the face. There are a number of additional symptoms of the disease which are given below-

  • Sudden onset of muscle failure and paralysis
  • Involuntary movement of the facial muscles
  • A lopsided expression or smile
  • Unilateral paralysis and loss of control (occur only on one side of the face)
  • A feeling of heaviness in the face
  • Difficulty talking, smiling, chewing or raising the eyebrows
  • Drooling from one side of the mouth
  • Alteration in the amount of saliva produced
  • Trouble closing one eye (usually the affected eye)
  • Irritation and dryness of the eye(s)
  • Bad taste in the mouth (to due dysfunctions of the chorda tympani nerve)
  • Alteration of taste sensation (on the affected side of the tongue)
  • Pain around the ear
  • Lack of facial expression
  • Incomplete closure of the upper eyelid
  • Reduced blinking
  • Drooping of the lower eyelid
  • Soreness and redness of the eyes
  • Impaired vision since the tears are not spread uniformly over the eye(s) (the affected eye)
  • Watering of the affected eye (due to loss of movement of the tear to the tear drainage ducts)
  • Alteration in the amount of tear produced
  • Facial tingling
  • Loss of sensation on the affected side
  • Sensitivity to loud noise (hyperacusis)
  • Headache
  • Memory problems

 

How can Bell’s Palsy be diagnosed?

Bell’s Palsy can be diagnosed through a few simple laboratory examinations. These are given below-

  • Cranial ultrasound: Used for high-risk premature infants.
  • CT scan: Detects brain injury.
  • MRI scan: Studies the brain tissues and structures.
  • Blood tests: To detect infections.
  • Physiological and neurological examination: Checks the facial nerve functions.

Differential diagnosis should be carried out to rule out other neurological diseases like Lyme disease, brain tumour, and stroke.

 

Treatment & Care

Bells palsy in seniorsBell’s palsy is usually treated with Aciclovir for 10 days and steroid tablets for 16 days. Given below are some of the short-term treatment techniques for the disease.

  • Drops and Ointments: Eye-drops like Liquifilm, Tears Naturale, and Hypromellose can maintain moisture and comfort in the eyes. Lacrilube eye ointment should be used at night in order to protect the eye. If the condition is serious, the patient is usually advised to apply the drops during the day as well.
  • Taping: A sticky tape can be used at night to keep the eye shut or to uplift a drooped eyelid.
  • Wrap-around sunglass: It helps protect the eye from wind, dust, and sunlight when the patient is outdoors.
  • Moist chamber: It helps in moisture retention in the eyes.
  • Punctal plugs: These are tiny stoppers inserted into the tear ducts to prevent an excess drainage of tears.
  • Botox: It is applied as a small injection into the upper eyelid. It weakens the muscle that opens the eye.

There are some extreme cases of Bell’s palsy where the eyelids do not close fully. Hence it becomes very difficult to protect the eyes from drying up. Surgical procedures like lateral tarsorrhaphy, medial canthoplasty or drooping eyebrow surgery are recommended in such cases. Proper care and medical attention are necessary after these surgeries in order to avoid post-operative complications.

 

 

Dos and Don'ts

Dos
  • Bell’s palsy is usually treated with steroids and antiviral drugs. It is important to protect and lubricate the eyes during the treatment with the help of prescribed eye drops.
  • Protect your eyes from dust and debris. Keep them covered during night time with a tape. Wear sunglasses during the day.
Don'ts
  • Strain your facial muscles.
  • Use a straw to drink liquids. Eat foods which require minimum to zero chewing.
  • Expose yourself to cold temperatures.
  • Continue rigorous physical activities. If you have an exercising routine, take a break from it till the doctor says its fine to resume physical activities.

 

 

 

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Common diseases that could cripple your vital organs Brain, heart, kidney, lungs, and liver - these vital organs are indeed vital for your survival. However, these…
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How to correctly perform nasal irrigation using a Neti Pot? Neti pot has been a part of Ayurveda since centuries. This ancient tool is extremely effective in treating…
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5 things you didn’t know about balneotherapy and how you can do it at home Sauna baths have been popular since a long time. But how much more beneficial can balneotherapy be as…
cytomegalovirus iGG
Cytomegalovirus (CMV)- IgG Test The cytomegalovirus IgG is the immunoglobulin protein produced by our immune system when the body is infected by…
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Milk Thistle: Find possible cures for fatal diseases in these purple blooms Milk thistle is well-known for treating liver conditions. However, did you know that it comes with a plethora…
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Meal replacement or protein drink? Learn all about Shakeology and its claims Shakeology from Beachbody claims to be the most suitable shake that can aid in weight loss, regulate blood…
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Tamarind: The top health benefits of this staple Asian ingredient Did you know this sweet and sour pulpy fruit does more than just add a tangy flavor to…
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Creatinine Test The level of creatinine in the blood is a significant indicator of the health of your kidneys. This…
top 10 deadliest diseases
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Anti-Inflammatory foods: 18 foods to a disease-free you Anti-inflammatory foods are the foods which are known to reduce the inflammation as well as the pain from…
Kava: Is it the healthy substitute for alcohol you have been waiting for? Native to the beautiful South Pacific islands, Kava is a famous beverage rooted in the local culture. It…
Jack in the box fast food
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beta hcg test
Beta hCG Test A Beta hCG test measures the level of human gonadotropin hormones present in the blood that is primarliy…
GM Diet: The fastest way to lose weight or yet another hoax diet? General Motors started this trend of extreme dieting for 7 straight days to ensure its employees were able…
antiHEV IgM test
Anti hepatitis E virus (Anti HEV) IgM Test Anti HEV IgM test determines the level of the IgM antibodies in the blood, The disease is often…
General adaptation syndrome: Understanding stress, one step at a time The struggle of the body to produce hormones during a stressful situation is the main theme of general…
Dragon Fruit – Blessing from Nature’s Basket Dragon fruit is packed with nutrients but low on calories. It is the dream food that can help…
blood ketone test
Blood Ketone (D3HB) Test The Blood Ketone Test measures and monitors the levels of ketone in the blood which is usually performed…
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8 hidden causes of obesity you probably didn’t know! Did you know that around 2 billion people worldwide are either overweight or obese? Are you too a…
C-Reactive Protein Test A CRP or c-reactive protein blood test is an important diagnostic tool used to determine the risk of…
understanding addiction
Addiction explained: An obsession that could cost you your life Is addiction a behavioral disorder? Or is it a chronic disease? How does addiction cause chemical and structural…
chloride test
Chloride Test A chloride test of the blood checks the level of chloride in body, an important factor governing the…
kidney stones
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tonometry
Tonometry Tonometry uses a device called tonometer to measure the pressure inside the eye. This pressure is depends upon…
Juice Plus: Can you really replace actual fruits with pills?  Juice Plus supplements intend to fill nutritional gaps present in our daily diet. But how successful have they…
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