Just imagine you had a nightmare last night, where you are awake in morning and you find out that you are not able to move one of your facial muscles or your eyebrows. You see the mirror and scream, but only your voice is heard without any facial action. Does this nightmare hurt you and makes you feel sad? Yes, obviously it can and such dream makes everyone scared. Well, this might happen for few in their life. The fact is, there is a scientific medical terminology for the incidence of your nightmare and it is called Bell’s palsy or Facial Paralysis.
Bell’s palsy is a paralysis or severe weakness of facial muscles on one side of the face, mainly resulting from temporary or permanent damage to the facial nerve. It gets the name from 19th century Scottish anatomist and surgeon, Charles Bell, who discovered that severing the 7th cranial nerve causes facial paralysis. Bell’s palsy is the most common cause of facial paralysis, affecting 1 in 5000 people every year and is mostly seen in age group of 18 to 60 years. Versatile Bollywood actor Anupam Kher suffered from Bell’s palsy during shooting of blockbuster movie, Hum Aapke Hain Koun, while Rahul Sharma, Indian cricketer who came into limelight in 2011 IPL, also suffered from Bell’s palsy in the year 2010. Actor, director, producer George Clooney and James Bond starrer Pierce Brosnan too suffered from Bell’s palsy.
The exact cause of Bell’s palsy is not yet known, but scientists believe that it is caused by herpes virus which causes cold sores and genital herpes. Other viruses too have shown linked to Bell’s palsy like the chicken pox virus, shingles virus, Epstein-Barr, cytomegalovirus, mumps virus Influenza B and hand, foot and mouth disease virus.
One of the study carried out in 2015 states that person with migraine have higher risk of Bell’s palsy. Other people at risk are those having diabetes or upper respiratory disease, HIV patients and pregnant women during the last trimester.
Facial nerves have so many functions that damage to any of the nerve can have many complications. The symptoms of Bell’s palsy develop quickly and reach their peak within 48 hours. The following symptoms vary from mild to severe.
- Acute onset of upper and lower facial paralysis
- Blurred vision
- Decreased tearing
- Disturbance in taste
- Drooling form one side of mouth
- Facial muscle weakness
- Pain in ear or mastoid
- Pain in eye
- Posterior articular pain
- Tingling or numbness of cheek or mouth
- When patient raises eyebrows, palsy affected side of forehead remains flat
- When patient smiles, face becomes distorted
Person should visit doctor as soon as he or she suspects Bell’s palsy. Research indicates that the best time in which Bell’s palsy will respond to treatment is within 72 hours from time of its onset. Doctor will carry out neurological examination. Doctor will ask to do some facial movements like closing eyes, puckering of lip, raising eyebrows and smiling. Doctor might advise for some tests in order to eliminate potential causes like:
- A nerve test called electromyography is advised after the immediate onset of facial paralysis to identify which nerve is causing the problem
- Blood test to rule out Lyme disease and Ramsay Hunt Syndrome
- Ear, Neck and Throat test
- MRI and CT scan to rule out tumors
Some people who have Bell’s palsy do not require any treatment, as it gets recovered in 1 to 2 months, especially in those who still have some degree of facial movements. For others the treatment may differ depending on the form of problem whether mild or severe. They include:
- Sometimes antivirals are given along with prednisolone to treat Bell’s palsy
- Topical ocular lubrication is advised to prevent drying of eyes, abrasion and ulcers
- Treatment with hormone called prednisolone with 72 hours from onset of paralysis shows speedy recovery
Most people with Bell’s palsy recover within 9 months from the time of treatment. If the recovery is not full then there is risk of more nerve damage and hence further treatment would be required. This includes:
- Botulinum toxin injections – some of the long term complications of Bell’s palsy are treated using Botox injections like tears while eating and winking eyes while eating, smiling or laughing.
- Physiotherapy – physiotherapist would teach more of facial exercise that will strengthen the muscles in order to improve co-ordination and range of movement.
- Plastic surgery – it may not restore the nerve function, but may be able to protect your eye movement, smile and appearance of face. Though it is costly, it is very important to select paralysis certified surgeon who has assisted many surgeries.
The most important thing to remember is not to panic. Discovering that you have Bell’s palsy can be frightening at time, but it is also important to speak to your doctor and get treated as soon as you see the symptoms. In many cases, it is found that treatment within 72 hours of its onset is very effective and leaves you with minimum damage to your face.
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Radha K. Iyer is a contributing writer on Treatum Blog. When she is not writing, she can be found reading health and food blogs or experimenting with her culinary skills.
Disclaimer: The entire content of this article is for information purpose only and is not intended to replace a one-on-one relationship with a qualified health care professional. It is intended as a sharing of knowledge and information. It is not a substitute for professional care and should not be used for diagnosing or treating a health problem and disease.