Description

Bell's palsy is a condition that causes sudden weakness in the muscles on one side of the face. Often, the weakness is short-term and improves over weeks. The weakness makes half of your face appear to droop. The smiles are on one side only, and the eye on the affected side is difficult to close.

Bell's palsy is also known as the syndrome of acute peripheral facial palsy of unknown cause. It can occur at any age. The exact cause is not known. Experts believe that it is caused by swelling and irritation of the nerve that controls muscles on one side of the face. Bell's palsy can be caused by a reaction that occurs after a viral infection.

The symptoms usually begin to improve within a couple of weeks, with complete recovery in about six months. A small number of people continue to have some Bell's palsy symptoms for life. Rarely, Bell's palsy occurs more than once.

Symptoms

The symptoms of Bell's palsy appear suddenly and may include:

  • Mild weakness to total paralysis on one side of the face — that occur within hours to days.
  • Facial droop and difficulty making facial expressions, such as the closure of an eye or a smile.
  • Drooling.
  • Pain around the jaw, or pain in or behind the ear on the affected side.
  • Increased sensitivity to sound on the affected side.
  • The pain of a headache.
  • The loss of taste.
  • Changes in the amount of tears and saliva produced.

Rarely, Bell's palsy can affect the nerves on both sides of the face.

When to see a doctor

Seek medical help immediately if you experience any kind of paralysis due to that you may have a stroke. Bell's palsy is not caused by a stroke, but the symptoms of both conditions are similar.

If you have facial weakness or drooping, consult your health professional to determine the cause and severity of the disease.

Causes

Although the exact cause of Bell's palsy occurs is not clear, it is often related to a viral infection. Viruses that have been linked to Bell's palsy are the viruses that cause:

  • Cold sores and genital herpes, also known as herpes simplex.
  • Chickenpox and herpes zoster, also known as herpes zoster.
  • Infectious mononucleosis caused by the Epstein-Barr virus.
  • Infections caused by cytomegalovirus.
  • Diseases of the respiratory tract, caused by adenovirus.
  • Rubella, also known as rubella.
  • Mumps is caused by the mumps virus.
  • The flu, also known as influenza B.
  • Hand-foot-and-mouth disease, caused by a coxsackie virus.

The nerve that controls the facial muscles is passed through a narrow corridor of bone on its way to the face. In Bell's palsy, the nerve becomes inflamed and swells — usually related to a viral infection. In addition to affecting the facial muscles, the nerve that affects the tears, saliva, taste and a small bone in the middle of the ear.

Risk factors

Bell's palsy occurs more often in people who:

  • Being pregnant, especially during the third trimester, or who are in the first week after giving birth.
  • You have an infection of the upper respiratory tract, such as the flu or a cold.
  • You have diabetes.
  • You have high blood pressure.
  • Have obesity.

It is unlikely that the Bell's palsy to return. But when you do, there is often a family history of repeated attacks. This suggests that Bell's palsy may have something to do with genes.

Complications

Mild symptoms of Bell's palsy usually disappear within a month. The recovery of the most complete paralysis of the face may vary. Complications can include:

  • Irreversible damage to the facial nerve.
  • Spot the regeneration of nerve fibers. This can result in the involuntary contraction of certain muscles when you are trying to move to other muscles, known as synkinesis. For example, when you smile, the eye on the affected side can be closed.
  • Partial or complete blindness of the eye that will not close. This is caused by the excessive dryness and scratching of the clear protective covering of the eye, known as the cornea.

Diagnosis

There is no specific test for Bell's palsy. Your healthcare provider looks at your face and asks you to move your facial muscles. It asks you to close your eyes, lifting your brow, showing your teeth and frowning, among doing other movements.

Other conditions, such as a stroke, infections, Lyme disease, inflammatory conditions and tumors — can cause facial muscle weakness that mimics the Bell's palsy. If the cause of your symptoms is not clear, your health care professional may recommend other tests, including:

  • Electromyography (EMG). This test can confirm the presence of nerve damage and determine how severe it is. An EMG measures the electrical activity of a muscle in response to stimulation. It also measures the nature and speed of the conduction of electrical impulses along a nerve.
  • Imaging tests. Magnetic resonance imaging (MRI) or computed tomography (CT) may be necessary at times to rule out other possible sources of pressure on the facial nerve, such as a tumor or a fracture of the skull.
  • Blood tests. There is no blood test for Bell's palsy. But they can also use blood tests to rule out Lyme disease and other infections.

Treatment

Most people with Bell's palsy recover completely, with or without treatment. There is No one-size-fits-all treatment for Bell's palsy. But your health care professional may suggest medications or physical therapy to help speed your recovery. Surgery is rarely an option for Bell's palsy.

Because the eye on the affected side is not closed, it is important to take measures to protect and take care of the eyes. The use of lubricating eye drops during the day and an ointment for the eyes at night to help keep the eye moist. The use of glasses or goggles during the day and an eye patch at night to protect your eyes from hurt or scratched. You may need to see a health care professional to monitor your eye.

Medications

Commonly used medicines for the treatment of Bell's palsy include:

  • Corticosteroids, such as prednisone (Rays, Prednisone Intensol). These are powerful anti-inflammatory agents. If they can reduce the inflammation of the facial nerve, the nerve can comfortably fit within the bones of the corridor that surrounds it. Corticosteroids may work best if they are started within several days of the date of onset of symptoms. Steroids are started at the beginning to improve the likelihood of full recovery.
  • The antiviral drugs.The role of antiviral drugs is not true. Antiviral drugs alone have shown no benefit compared with placebo. The antiviral added to steroids may benefit some people with Bell's palsy, but this is not yet proven. Despite this, an antiviral medication, such as valaciclovir (Valtrex) acyclovir, is sometimes given in combination with prednisone in people with disease of facial paralysis.

The antiviral drugs. The role of antiviral drugs is not true. Antiviral drugs alone have shown no benefit compared with placebo. The antiviral added to steroids may benefit some people with Bell's palsy, but this is not yet proven.

Despite this, an antiviral medication, such as valaciclovir (Valtrex) acyclovir, is sometimes given in combination with prednisone in people with disease of facial paralysis.

Physical therapy

Paralyzed muscles can contract and shorten, which can be permanent. A physical therapist can teach you how to massage and exercise of the muscles of the face to help prevent this from happening.

Surgery

In the past, the decompression surgery was used to relieve pressure on the facial nerve through the opening of the bony passage in which the nerve passes through. Today, decompression surgery is not recommended. Facial nerve injury and permanent hearing loss are the possible risks associated with the surgery.

Rarely, surgery may be required to correct the duration of the facial nerve problems. Facial reanimation surgery helps the face look more uniform, and you can restore facial movement. Examples of this type of surgery include a brow lift, an eyelid lift, facial implants, and grafts of nerve. Some procedures, such as brow lift, you may need to be repeated after a number of years.

Lifestyle and home remedies

Home treatment may include:

  • Taking pain relievers. Aspirin, ibuprofen (Advil, Motrin IB, others) or acetaminophen (Tylenol, others) are available without a prescription and can help relieve your pain.
  • Doing physical therapy exercises. The massage and the exercise of his face, according to his physical therapist can help to relax the muscles of the face.

Alternative medicine

Although there is little scientific evidence to support the use of alternative medicine for the treatment of Bell's palsy, some people with this condition can benefit from the following:

  • Acupuncture. The placement of thin needles in certain points of the skin helps to stimulate the nerves and muscles, which may offer some relief.
  • Biofeedback training. By teaching you to use your thoughts to control your body, biofeedback training can help you have a better control over his facial muscles.
  • OnabotulinumtoxinA (Botox). This medication can help to control symptoms such as spasms of the face and tearing. Injection of onabotulinumtoxinA can also help to improve the balance of the face.

Preparing for your appointment

You can start by seeing your health care professional. You may be referred immediately to a doctor who specializes in the nervous system, known as a neurologist.

It is good prepare for your appointment. Here's some information to help you prepare.

What you can do

  • Write down any symptoms you are experiencing. Be sure to include any that may seem unrelated to the reason for which you scheduled the appointment.
  • Write down key personal information. Have you had any of the main stress or life changes recently? To share this type of information can help with the diagnosis.
  • Make a list of all the medications. Include the dose of any medication you are taking. Write down any vitamins or supplements that you are taking too much.
  • Have a friend or family member, if possible. Sometimes it can be difficult to remember all information that is obtained during an appointment. Someone who comes with you may remember something that you missed or forgot.
  • Write down the questions that you want to do.

Prepare a list of questions will help you make the most of your time with your health care professional. For Bell's palsy, some basic questions to ask include:

  • What is the most likely cause of my symptoms?
  • There are other possible causes of the symptoms?
  • What kinds of tests do I need?
  • It is this condition likely temporary or long-term?
  • What treatments are available for Bell's palsy? Which would I recommend?
  • There are alternatives to the primary approach you're suggesting?
  • I have other health conditions. How can I best manage these conditions?
  • Are there brochures or other printed material that I can take my house? What sites do you recommend?

Do not hesitate to ask any additional questions that occur during your appointment.

What to expect from your doctor

Be prepared to answer questions such as:

  • When did you begin to have symptoms?
  • The symptoms been continuous or occasional?
  • How severe are the symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Some of his relatives had Bell's palsy or problems with facial paralysis?
  • Have you had symptoms of generalized infection?

What you can do in the meantime

If you have facial pain:

  • Take pain relievers. Aspirin, ibuprofen (Advil, Motrin IB, others) or acetaminophen (Tylenol, others) may help with the pain.
  • Apply moist heat. Put a cloth soaked in warm water on your face several times a day can help relieve the pain.

If the eye does not close completely, try these tips:

  • Use your finger to close his eye repeatedly throughout the day.
  • The use of lubricating eye drops.
  • Wear safety glasses during the day to protect your eyes.
  • To wear an eye patch at night.
Symptoms and treatment of Bell's palsy