Bell's Palsy: Causes, Symptoms, Risk Factors, Diagnosis, Treatment and Complications

Sudden weakness in the muscles on one side of the face is a symptom of Bell's palsy.

The weakness is usually only temporary and goes away over a few weeks. The thinning gives the lower part of the face a sagging appearance. The afflicted eye resists closing when you smile one-sidedly.

Another name for Bell's palsy is acute peripheral facial palsy of unclear origin. It can take place at any age. Unknown is the exact cause. The nerve that manages the muscles on one side of the face is swollen and inflamed, according to specialists. It might result from an immune reaction to a viral infection.

Causes Of Bell's Palsy

Viral infections are usually connected to Bell's palsy even if its precise origin is unknown. Bell's palsy has been linked to viruses that cause the following conditions:

• Herpes simplex genital herpes and cold sores
• Herpes zoster and chickenpox
• Epstein-Barr virus( infectious mononucleosis)
• Infections with the cytomegalovirus
• Adenovirus-related respiratory diseases
• Rubella
• The mumps virus
• Influenza(type B)
• Coxsackievirus, or hand, foot, and mouth illness

The nerve controlling facial muscles passes via a small bone passageway on its journey to the face. Bell's palsy, which is often caused by a viral infection, causes that nerve to swell and become inflamed. The nerve not only controls the face muscles but also taste, saliva, tears, and a little bone in the centre of the ear.

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Symptoms Of Bells Palsy

Symptoms typically begin to improve within a few weeks, and a full recovery takes around six months. In a small number of cases, some Bell's palsy symptoms can persist for the rest of a person's life. Rarely does Bell's palsy occur more than once.

Bell's palsy symptoms and signs might include the following and appear suddenly:

• On one side of your face, you suddenly develop a moderate weakness that quickly progresses to complete paralysis within hours or days.
• Trouble expressing yourself facially, such as by smiling or closing your eyes
• Facial droop and trouble-producing facial gestures like smiling or closing your eyes
• Drooling
• Pain in the jaw region, near or behind your ear
• Enhanced acoustic sensitivity on the afflicted side.
• Headache
• Lack of taste
• You create different amounts of saliva and tears.
• The nerves on both sides of your face can very seldom be affected by Bell's palsy.

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Risk Factors Of Bell's Palsy

Bell's palsy occurs more frequently in those who:

• Who are in the first week after giving birth or who are pregnant, especially during the third trimester
• Have a cold or the flu that has spread to your upper respiratory system.
• Have high blood pressure with diabetes
• Obesity
• Bell's palsy bouts that recur seldom happen. However, there is frequently a familial history of recurring episodes when they do occur. This shows that your genes may have a role in Bell's palsy.

Diagnosis Of Bell's Palsy

The Bell's palsy condition has no specific test. Your doctor may ask you to perform specific facial actions, such as frowning, showing your teeth, arching your brow, or closing your eyes, while examining your face.

Other illnesses that can produce facial muscle paralysis that resembles Bell's palsy include strokes, infections, Lyme disease, inflammatory conditions, and tumors. If the source of your symptoms is unclear, your doctor can suggest more tests, such as:

EMG: Electromyography

This examination can evaluate the extent of nerve injury and confirm its presence.An EMG records the electrical response of a muscle to stimulus. It also measures the kind and speed of electrical impulses travelling along a nerve.

Scanning images

• When other potential sources of pressure on the facial nerve, such as a tumor or skull fracture, are ruled out, magnetic resonance imaging (MRI) or computerized tomography (CT) may be required.
• A blood test. Bell's palsy cannot be diagnosed through blood work. Blood testing can be performed to rule out other illnesses and Lyme disease, though.

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Treatment Of Bells Palsy

Patients with Bell's palsy frequently recover fully, either with or without therapy. There is no one Bell's palsy treatment that works for everyone. However, your doctor might advise using medicine or doing physical therapy to quicken your recovery. Surgery is rarely an option for Bell's palsy patients.

It's crucial to take action to safeguard and take care of that eye because the eye on the affected side doesn't close. You can keep your eye moist by using lubricating eye drops throughout the day and an eye ointment at night. Your eye can be protected from being poked or scratched if you wear glasses or goggles during the day and an eye patch at night. An eye doctor may need to keep an eye under observation in severe Bell's palsy situations.

Medications

Treatments for Bell's palsy frequently involve the following:

• Corticosteroids. These anti-inflammatory medications have a lot of power. If they can lessen the facial nerve's enlargement, the nerve will be able to fit more easily within the bone corridor that surrounds it. When used within a few days after the onset of your symptoms, corticosteroids may perform best. The likelihood of a full recovery is increased when steroids are started early.
• Antiviral medications. Antivirals still have an uncertain role. When compared to a placebo, using antivirals alone has not proven beneficial. Bell's palsy sufferers may find some relief with antivirals coupled to steroids, but this has not yet been proven.

Nevertheless, in patients with severe facial palsy, a combination of prednisone and antiviral medication, such as valacyclovir or acyclovir may be administered.

Physical exercise

Paralysed muscles can shorten and contract, which may be irreversible.Your facial muscles can be massaged and worked out by a physical therapist to help stop this from happening.

Surgery

Decompression surgery, which involves widening the bone channel that the facial nerve travels through, was once employed to release pressure on the nerve. Decompression surgery is not advised today. This operation may come with hazards like permanent hearing loss and facial nerve damage.

Rarely, permanent facial nerve issues may require plastic surgery to be fixed. Surgery to restore facial movement and level out the face's appearance is known as facial reanimation. These procedures include nerve grafts, eyelid lifts, face implants, and brow lifts as examples. After a few years, some treatments, like a brow lift, might need to be redone.

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Complications Of Bell's Palsy

Bell's palsy symptoms normally go away in a month for mild cases. When the face is entirely paralyzed, recovery from such a case can be extremely difficult. Problems could arise because of:

• Face nerve injury that cannot be repaired.
• Abnormal nerve fiber regeneration. Because of this, you could experience synkinesis, or the unintentional contraction of certain muscles while trying to move others. The eye on the impacted side might close, for instance, when you grin.
• Blindness of the weak eye, either partially or completely. The clear protective layer (cornea) of the eye is damaged as a result of severe dryness and scratching.

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