Bell’s Palsy: The Unexplainable Disorder

Bell’s Palsy is a rare unexplained episode of facial muscle weakness or paralysis that begins suddenly and worsens over three to five days. This condition results from damage to the 7th (facial) cranial nerve, and pain and discomfort usually occurs on one side of the face or head.

How do you get it?

The cause of Bell’s Palsy is unknown. Generally it is thought to be caused by a viral infection such as Herpes Simplex II (Cold sore), stress, influenza or a flu-like illness, and trauma such as skull fracture or facial injury.

Who Gets It?

Anyone can get Bell’s Palsy, but it is highest in pregnant women, diabetics, and those who between the ages of 16 and 60. This nerve disorder affects about 40,000 US adults and children each year. Bell’s palsy strikes men and woman equally.

Diagnosis:

Diagnosing Bell’s Palsy is mainly the elimination of other things. Usually an X-ray of the skull will help. There are no lab tests available. Mainly the person will be required to person some basic face skills like smile, blink; close the eye without assistance, etc.
Further, they need to make sure that it is limited to the face and not the rest of the body. If it has affected somewhere below the neck, then it is not Bell’s Palsy. Generally, it is quick to diagnose if it was a quick onset.

Symptoms:

� disordered movement of the muscles that control facial expressions such as smiling, squinting, blinking, or closing the eyelid
� 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

The symptoms vary from person to person. Some have a quick onset, while others show a progression over a few days. It can be as intense as waking up in the morning to see your face seems frozen, and you are in a lot of pain. The side of the face that has been affected is drooped downward, there may be difficulty closing the eye, the inability to smile, and drooling when eating or drinking.

It depends on the severity of the trauma how the face will look. If it is mild, it could just affect the mouth and eyes. In the most severe cases there will be the inability to close the eye at all, which could lead to eye damage if it is not kept moist through artificial tears and taping the eye shut. Sometimes the symptoms can just be a weakness in the face and not paralysis.

The cranial muscle is inflamed, swollen, or compressed, which is painful since this gives the appearance of one side of your face being swollen. It will also have a huge affect on your hearing since the muscle runs below the ear. If the symptoms progress slowly one could think they have an ear infection, tooth abscess, or some other problem. It may have to progress to the point of being noticeable on the face before proper diagnosis is made.

Treatment

There is no treatment or cure for Bell’s Palsy. Depending on the severity of the event, a person could be better in as little as two weeks. The more progressive means longer healing time.

Generally patients are prescribed some steroids to stop the progression of the disease. It is for up to ten days, several times a day. The steroids must be started within 3-5 days in order for it to have an affect.

Pain is managed through over-the-counter drugs. The point is to get the swelling down to eliminate the pain and start facial exercises.

Recovery

50% of those with Bell’s Palsy will have complete recoveries in a really short period of time. 35% will have good recoveries in less than a year. The rest may require more time to heal.

The “average” recovery can take between a few weeks and a few months. The nerves regenerate each day, and can continue to regenerate for 18 months, and sometimes longer. Appearance can continue well beyond this time frame.

In a few cases, the symptoms may never disappear. In rare cases, the disorder can recur, either on the same or the opposite side.

Most people do facial exercises/physical therapy to strength and retrain the muscles. It is important that people make sure the muscles do not become constricted. The exercises are thought to be affective regardless of when started. In rare cases surgery may be used to decompress the muscle, but this is controversial and seldom used.

Recurrence

The rate of recurrence is between 4-14 %. The average span between recurrences is 10 years.

After Affects

The pain and swelling are gone, but the healing continues. Each week there is some other affect such as, the nostril running, eye watering, or something else. By retraining the muscles, they will lessen.

It can take months to get things back in line, but it is worth it.

Some people have psychological affects. They seem self-conscious about the inability to smile or make facial expressions. Some who are not aware of the disorder may misread their expressions. The good news is that it goes away for the majority of those affected.

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