Bell's Palsy HomePage

 

What is Bell's Palsy?

 

Bell's palsy (BP) also called facial nerve palsy, is usually a unilateral (one-sided) facial paralysis that occurs suddenly and worsens over a period of hours to days. This condition results from damage to the 7th (facial) cranial nerve, and may be accompanied by pain or discomfort on one side of the face and head. Dysfunction of the facial nerve can occur through several different mechanisms: compromise of the blood supply to the nerve; inflammation and edema within the nerve; immune reaction; or viral infection. BP is the most common cause of facial paralysis affecting approximately 40-65,000 persons every year in the United States. BP mostly affects young and middle-aged adults. Bell¹s palsy strikes men and woman equally, usually between the ages of 19 and 60, although men seem to be at higher risk as the reach the age of 30 and over. It is seen three times more common in pregnant women, or persons with diabetes, influenza, colds (as the virus HSV I indicates), or other respiratory ailments which may account for why the incidence rises again well after the age of 60. Recent research has provided evidence that the herpes simplex virus (HSV) may play an important role in as many as 70% of BP cases. HSV is the same virus that causes cold sores and lives in nerves.

 

What is the History of Bell's Palsy?

The disorder is named for Sir Charles Bell, a Scottish surgeon and physiologist, for his work on facial palsy. In 1821, Bell demonstrated that the facial nerve, the seventh cranial nerve, was a separate nerve primarily responsible for innervating the muscles of the face.

What are the major symptoms of Bell's Palsy?
Although symptomatic manifestations of Bell's Palsy vary according to the individual, the following are considered the most common symptoms to be aware of:

• loss of feeling in the face
• headache
• tearing
• drooling
• loss of the sense of taste on the front two-thirds of the tongue
• hypersensitivity to sound in the affected ear
• inability to close the eye on the affected side of the face
• affects the muscles that control facial expressions such as smiling, squinting, blinking, or closing the eyelid

Since the symptoms may be easily confused with other medical conditions it is important that all sufferers of unilateral facial paralysis are diagnosed by a trained physician.

What causes may be linked to Bell's palsy?
A specific cause of Bell's palsy is unknown, however, it has been suggested that the disorder may be inherited since occurrence rates in families is 10%.  It also may be associated with:

• diabetes
• high blood pressure
• trauma
• toxins
• Lyme disease
• Guillain-Barre syndrome
• sarcoidosis
• myasthenia gravis
• infection

Treatment for Bell's palsy:
One uniformly recommended treatment for Bell's Palsy is protecting the eye from drying at nighttime. Eye care, which may include eyedrops during the day, ointment at bedtime, and a moisture chamber at night, helps to protect the cornea from scratching, which is crucial to the management of Bell's palsy.

Prognosis of Bell's Palsy:
Currently, there is no known cure for Bell's palsy. Recovery usually begins 3 weeks to 6 months from the onset of the symptoms. Recurrence of symptoms at a future time is rare, although some patients do experience residual problems. The majority of people with Bell's palsy recover full facial strength and expression, usually over weeks to months. Typically, it improves in 4-6 months and almost always by 12 months.

In rare instances a person with Bell¹s may have a delayed recovery period, since in the event nerve damage they may not fully recover all. SLP treatment is recommended to assist in minimizing long-term damage and disability as well as assisting in the compensatory behavior training during the recovery period.