Insight and understanding into Bell’s palsy

Imagine waking up discovering you’ve lost the ability to control one side of your face.  One eyelid is drooping, there is drool coming out of the corner of your mouth and attempts to smile results in a lopsided grin.  These are just a few of the symptoms someone with Bell’s palsy will experience.  Bell’s palsy, the most common cause of facial paralysis, is a form of temporary facial paralysis resulting from damage or trauma to the facial nerves.

This rare condition is named for Sir Charles Bell, a 19th century Scottish surgeon who described the facial nerve and its connection to the condition. 

Until we lose our ability to have facial expressions, we have no idea how important our facial nerve is. Blinking our eyes, smiling, frowning, and even detecting taste sensations from the tongue, all rely on our facial nerve which is responsible for directing the muscles in our face giving us the ability to show facial expressions. 

What is Bell’s palsy?

Bell’s palsy is a condition causing only one side of your face to be weak or paralyzed.  It is due to a disruption of the functioning of the facial nerve, causing an interruption in the messages the brain sends to the facial muscles leading to facial weakness or paralysis. The facial nerve is a peripheral nerve responsible for facial movement.

The condition is often confused for a stroke, however, a stroke will also cause muscle weakness in other parts of the body and not just one side of the face.  It is a relatively rare condition affecting around 40,000 Americans each year. 

What causes it?

The exact cause of Bell’s palsy is unknown. What has happened though is some sort of damage or trauma to the seventh cranial nerve or facial nerve.  This nerve passes through a very small area in the skull and if the nerve is damaged it will swell, causing the nerve to push up against the skull.  

Many scientists believe this is a link between Bell’s palsy and viral infections such as influenza, herpes simplex or respiratory tract infections.  People with diabetes are also more suspect to the condition.  Pregnancy is the most well-established risk factor as Bell’s palsy occurs three times more frequently in pregnant women than in the general population, particularly in the third trimester and the first week after delivery.

 Other conditions associated with Bell’s palsy include high blood pressure, immunodeficiency, sarcoidosis, tumors, Lyme disease and trauma such as a skull fracture or facial injury.

What are the symptoms?

Sufferers with it develop one-sided facial weakness that may last a matter of hours to several months.  The effects of it can result in eyebrow sagging, inability to close or blink the eye, excessive tears, drooping of the mouth, drooling, difficulty chewing and tasting food, twitching, sensitivity to loud noises, and pain or numbness behind the ear. 

How is it treated?

Treatment of Bell’s palsy may vary based on the severity of symptoms.  The good news is that this condition has an excellent prognosis and recovery, even if it is not treated.  But, for some individuals, medications and other therapeutic options are necessary.  Common treatments include prednisone, antiviral agents and eye care to prevent corneal drying, abrasion and eye ulcers. 

The main goal of treating Bell’s palsy is to improve functioning of the facial nerve, reduce nerve damage and to protect the eye.  The vast majority of people who experience it will begin to feel better in a few weeks and most will make a full recovery within three months if not much sooner.