What is Bell’s Palsy? | What causes it? | Neurology

Bell's palsy

What is Bell’s palsy?

Bell’s palsy, also known as acute idiopathic peripheral facial palsy, can occur at any age. The exact cause of this disease is unknown. Bell’s palsy is intellection to be caused by swelling and inflammation of the nerve that standard the muscles on one side of your face. Or it may be a reaction that occurs after a viral infection.

Symptoms of Bell’s palsy consider emergent impotence in your facial muscles. In most cases, the weakness is temporary and significantly improves within weeks. Weakness makes half of your face look like it’s drooping. Your smile is on one side, and your eyes on that side are resisting closing.

For most people, Bell’s palsy is temporary. Symptoms usually begin to improve within a few weeks, with full recovery within about six months. A small number of people still experience some symptoms of Bell’s palsy for life. In rare cases, hemiplegia can recur.

What are the symptoms of Bell’s palsy?

Symptoms of Bell’s palsy can appear one to two weeks after you have had a cold, an ear infection, or an eye infection. It usually appears suddenly, and you may notice it when you get up in the morning or try to eat or drink.

Bell’s palsy is characterized by the appearance of drooping on one side of the face and the inability to open or close your eye on the affected side. In rare cases, Bell’s palsy hawthorn impact both sides of your face.

Other signs and symptoms include Bell’s palsy:

  • Drooling
  • Difficulty eating and drinking
  • Inability to express the face, such as smiling or frowning
  • Facial weakness
  • Facial muscle spasms
  • Dry eyes and mouth
  • Headache
  • Sensitivity to sound
  • Eye irritation on the affected side

Call your doctor straight away if you acquire any of these indications. You should never self-diagnose Bell’s palsy. Symptoms can be related to those of other thoughtful situations, such as a stroke or brain tumor.

What causes Bell’s palsy?

The cause of Bell’s palsy is unknown. In people with hemiplegia, swelling and inflammation of the seventh cranial nerve appear.

Most scientists believe that reactivating a (dormant) viral infection might cause the disorder. Impaired immunity from stress, sleep deprivation, physical trauma, mild illness, or autoimmune syndromes is suggested as the most likely trigger. When the facial nerve enlarges and becomes inflamed in response to an infection, it causes pressure within the fallopian tube (a bony canal through which the nerve travels to the side of the face), restricting blood and oxygen access to nerve cells. In some mild cases where recovery is rapid, there is only damage to the myelin sheath (the fatty covering that acts as a buffer for nerve fibers).

Many other conditions can also cause facial paralysis, for example, brain tumor, stroke, myasthenia gravis, and Lyme disease. If no specific cause can be identified, the condition can be diagnosed as Pelvic Palsy.

Bell’s palsy diagnosis

The American Medical Association (AMA) says the treatment is most effective when given early, so patients should see a doctor as soon as symptoms appear. The diagnosis of Bell’s palsy is often an excision. The doctor will look for evidence of other conditions that may cause facial paralyses, such as a tumor, Lyme disease, or a stroke.

They will examine the patient’s head, neck, and ears. They will also evaluate the facial muscles to determine if any nerves other than the facial nerve are affected. If all other causes can be ruled out, then a doctor will diagnose Bell’s palsy. If the diagnosis remains uncertain, the patient may be referred to an ear, nose, and throat (ENT) specialist or an otolaryngologist.

The specialist will examine the patient and may also order the next tests:

  • Electromyography (EMG): Electrodes are placed on the patient’s face. The device measures the electrical activity of nerves and the electrical activity of the muscle in response to stimulation. This test can determine the extent and location of nerve damage.
  • MRI, CT scans, or X-rays: These are good at determining whether other underlying conditions are causing the symptoms, such as a bacterial infection, skull fracture, or tumor.

Complications

Due to the complexity of the facial muscles and their functions, a number of problems can arise after a prolonged experience with Bell’s palsy:

  • Contracture: Shortening of the facial muscles over time may cause the affected side of the face to appear slightly “raised” compared to the unaffected side, and the affected eye may appear smaller than the healthy eye. The crease between the external edge of the nostril and the side of the mouth may seem further because of the expanded compression of the cheek muscles on this side.
  • Crocodile tears: This means that the affected eye is drooling involuntarily, especially while eating. This is due to a malfunctioning of the nerves “rewiring” during the recovery phase.
  • Lagophthalmos: This is the inability to close the affected eye, which if it persists for a long time may lead to dry eye and/or corneal ulceration. (These complications can be helped/prevented by the use of artificial tears and pressure on the eye at night.) In rare cases, vision may be permanently damaged if caution is not taken.
  • Synkinesis: This means that when you try to intentionally move one part of the face, another part moves automatically. For example, when an eye smiles on the affected side it automatically shuts off. Likewise, when raising the eyebrows or closing the eyes, there is an involuntary contraction of the cheek or neck muscles. Find out more about synkinesis.
  • People with persistent symptoms of Bell’s palsy may have psychological problems, including stress, anxiety, depression, and low self-esteem. Please see our support section for more advice.

How is Bell’s palsy treated?

If a specific cause of Bell’s palsy, such as an infection, is identified, that cause is treated. Otherwise, symptoms are treated as needed.

One of the commonly recommended treatments for Bell’s palsy is to protect the eyes from drying out at night or while working at a computer. Eye care may include eye drops during the day, an ointment at bedtime, or a damp room at night. This helps protect the cornea from being scratched, which is critical for managing Bell’s palsy.

Your healthcare provider will dictate some other treatment for your status based on the severity of your symptoms and your illness history. Other treatment options include:

  • Steroids to reduce inflammation
  • Antiviral medicine such as acyclovir
  • Analgesics or moist heat for pain relief
  • Physical therapy to stimulate the facial nerve

Some people may choose to use secondary medical care in treating Bell’s palsy, but there is no indication that they make a deviation in healing. This may include treatment:

  • Relaxation
  • Acupuncture
  • Electrical stimulation
  • Biofeedback training
  • Vitamin therapy, including vitamin B12, B6, and the mineral zinc

What are the risk factors for Bell’s palsy?

Your risk of developing Bell’s palsy is increased if you:

  • Pregnant
  • Diabetic
  • You have a lung infection
  • You have a family history of this condition

Outlook

Most people with Bell’s palsy recover without treatment. You should notice a gradual decrease in symptoms within a few weeks. Depending on the extent of the nerve damage, full recovery can take anywhere from two to six months. Some symptoms last longer, and some people never fully recover.

Prevention

At one time, exposure to cold air or strong winds was thought to be a predisposing factor to idiopathic facial nerve palsy (hemiplegia). We now know that these ideas were incorrect. Because the majority of cases of idiopathic facial nerve problems are unknown, it is difficult to predict with precision which specific elements to avoid. Choosing a healthy lifestyle to reduce the risk of diabetes, cancer, or infections may help prevent some cases of facial nerve paralysis.

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