BELL'S PALSY
BAsic information
description
A paralysis or weakness on one side of the face. The onset may be sudden, or may come on over several days. Bell's palsy involves a cranial nerve and the facial muscles that connect to the nerve.
frequent signs and symptoms
- Sudden paralysis on one side of the face, including muscles connected to the eyelid.
- Pain behind the ear on the affected side.
- Flat, expressionless features on one side of the face.
- Distorted smiles and frowns; drooling.
- Changes in taste, saliva, or tear formation.
causes
Unknown. The paralysis is probably caused by swelling of the facial nerve. The swelling may be caused by a viral infection of the facial nerve as it passes through the temporal bone of the skull.
risk increases with
- Common cold, flu, other respiratory infection.
- Pregnancy.
- Diabetes.
preventive measures
Cannot be prevented at present.
expected outcomes
- Bell's palsy causes distress, but it is not dangerous. The amount of nerve damage determines the extent of recovery.
- Improvement is gradual. Recovery time varies, and sometimes requires many months.
- Patients with mild facial paralysis usually recover completely in several months. Those with more severe facial paralysis recover completely in 80% to 90% of cases.
- Surgery may help improve facial appearance and muscle function in patients who do not recover fully.
POSsible complications
- Eye irritation or injury, because the eye does not close properly and is exposed to dust. If unprotected, the eye may develop ulcers on the cornea.
- Tooth decay and gum disease, due to reduced saliva and difficulty in chewing.
- Emotional and self-esteem problems.
diagnosis & treatment
general measures
- Your health care provider will do a physical exam of the affected area. Medical tests such as x-rays may be done to rule out other causes. A nerve study of the facial nerves may be done to determine the extent of nerve damage.
- If you have pain, apply heat to the area twice a day. Use a moist, warm towel and apply for 15 minutes. Cover or close the eye during heat treatments.
- If you cannot wink or close your eye well, you should buy a pair of wraparound, plastic sports goggles. Wear them to protect your eye from dirt, dust, and dryness.
- At night, apply an eye patch to shut the lid so that the eye stays moist and protected. Sometimes, a patch will be necessary during the daytime.
- As muscle strength returns, use facial massage and exercises. Massage muscles of the forehead, cheek, lips, and eyes using cream or oil. Exercise the weak muscles in front of a mirror. Open and close the eye; wink, smile, and bare your teeth. Perform the massage and exercises for 15 to 20 minutes several times a day.
- Brush and floss teeth regularly.
- Surgery on the facial nerve may (rarely) be needed.
medications
- Your health care provider may prescribe eye drops for comfort and protection of the exposed eye.
- Cortisone drugs are often helpful to reduce swelling and inflammation of the affected nerve.
activity
Maintain your normal activities. Rest does not help Bell's palsy.
diet
A soft diet is often necessary.
notify our office if
- You or a family member has symptoms of Bell's palsy.
- Your eye becomes red or irritated, despite treatment.
- You cannot prevent yourself from drooling.
- Pain worsens or fever occurs.
- New, unexplained symptoms develop. Drugs used in treatment may produce side effects.