A health condition that causes sudden muscle weakness on one side of the face is called Bell’s palsy. In most cases, weakness is temporary and improves over a few weeks. However, when it occurs it causes half of the face to droop and the eye of the affected part of the face is hard to close and smiles are only on the part of the face that is not affected.
This condition also is called acute peripheral facial palsy of unknown cause. Furthermore, it may occur at any age. Healthcare providers do not know what exactly causes this condition but they think swelling and irritation of the nerve that controls the face muscles could play a role. The nerve that controls a part of the face may be affected by a viral infection.
While symptoms improve within several weeks, a complete recovery may take up to 6 months. In addition, this condition may occur more times but very rarely and only a few people may experience Bell’s palsy symptoms for their entire life.
Symptoms
In most cases, the symptoms occur suddenly in people with Bell’s palsy. Check below some examples:
- Mild weakness to total paralysis on one face’s side.
- Facial droop and difficulty making facial expressions (including smiling, closing an eye, and others)
- Drooling
- Jaw pain
- Elevated sound sensitivity
- Headaches
- Loss of taste
- Changes in the amount of saliva and tear production
- Pain may also occur behind the ear on the affected face part
In rare cases, Bell’s palsy may negatively affect nerves on both face parts.
Immediately seek medical help if you experience any paralysis type because it may occur due to other health conditions (such as a stroke).
Causes
In most cases, this condition is related to viral infections although the exact cause is not known. Check below some viruses that are linked to Bell’s palsy:
- Cold sores
- Genital herpes (also called herpes simplex)
- Infectious mononucleosis (this condition occurs due to Epstein-Barr virus)
- Cytomegalovirus infections
- Respiratory conditions caused by adenovirus
- German measles (rubella)
- Mumps that occurs due to mumps virus
- Influenza B (also called flu)
- Hand-foot-and-mouth disease that happens due to coxsackievirus
In normal circumstances, the nerve that controls facial muscles goes through a narrow path of bone on its way to the face. In people with Bell’s palsy inflammation of the nerve occurs. Moreover, when this nerve is affected it also negatively affects taste, saliva, tears, and others.
Risk Factors
This condition happens more commonly in the following cases. For example:
- Pregnancy
- People with upper respiratory infection (including the flu or a cold)
- Diabetes
- Hypertension (high blood pressure)
- Obesity
This condition may return but in rare cases and when it occurs there is a family history usually. In such cases, there may be some genes that contribute to the recurrence of Bell’s palsy.
Complications
Commonly, a mild form of Bell’s palsy goes away on its own within 30 days. Recover from facial paralysis varies among people. Check below some complications that may occur due to Bell’s palsy:
- Permanent damage to the nerve that controls facial muscles
- Irregular regrowth of nerve fibers leads to involuntary muscle contractions when you move with other ones (also called synkinesis). For instance, when you are smiling, the eye of the affected face part closes.
- Partial or complete loss of vision of the eye that you are not able to close. In such cases, blindness commonly happens due to excessive dryness and scratching of the protective covering of the eye (known as cornea).
Diagnosis
However, there are no specific tests to diagnose Bell’s palsy. Therefore, doctors will perform a physical examination to check for symptoms and may ask you to move the facial muscles. You may also be asked to close your eyes, lift your brow, show your teeth, and do other movements.
Doctors may perform some tests to exclude other health conditions (such as a stroke, infections, Lyme disease, tumors and inflammatory conditions, and others) that cause similar symptoms to Bell’s palsy. Check below some examples:
- EMG (electromyography) – This test helps determine damage to the nerve and measure the electrical activity of a muscle in response to stimulation. It also helps doctors measure the speed and nature of the conduction of electrical impulses.
- Imaging tests – These include CT (computerized tomography) and MRI (magnetic resonance imaging) to exclude other conditions that cause similar symptoms.
- Blood tests – These tests cannot diagnose Bell’s palsy but may rule out Lyme disease and other infections.
Treatment
Commonly, people with this condition recover without treatment. However, there are no treatment options for Bell’s palsy but physicians may recommend medications, physical therapy, or surgery (rarely) to help recover faster.
People with Bell’s palsy usually are not able to close their eyes on the affected face part. Thus, you should take steps to protect the eye and prevent vision loss. You can use lubricating eye drops and eye ointment during nighttime. Moreover, it is recommended to wear glasses during the daytime.
Medications
The following medicines are usually prescribed by doctors for people with Bell’s palsy. For example:
- Corticosteroids – This group of medications is often recommended by doctors to lessen swelling (inflammation) of the facial nerve. Therefore, it may fit more comfortably within the bony hallway. Moreover, it is recommended to take these medications as soon as symptoms start.
- Antiviral drugs – These medicines alone do not provide any benefits compared with placebo but some people may notice improvements if take these medicines along with steroids. For instance, in people with severe Bell’s palsy, doctors may recommend taking Valacyclovir or Acyclovir with Prednisone.
Physical Therapy
Permanent shrinking and shortening of the paralyzed muscles may occur in people with this condition. However, a physical therapist may teach you how to massage and exercise the facial muscles to prevent this from happening.
Surgery
Previously, decompression surgery was used to lessen pressure on the facial nerve by opening the bony hallway but this surgery is not recommended because it may lead to facial nerve injury and certain symptoms. These include permanent hearing loss and other health problems.
In rare cases, doctors may recommend plastic surgery to correct facial nerve problems. Moreover, facial reanimation surgery also may be used to restore facial movement.
Frequently Asked Questions
Can stress cause Bell’s palsy?
No, alone it cannot cause the condition but healthcare providers believe it is a contributing factor. For more details, discuss it with your physician.
What is the primary symptom of Bell’s palsy?
The primary symptom of Bell’s palsy is facial muscle weakness or paralysis on one face side. However, you need to visit a doctor if the previous symptom occurs because there are different health conditions that may cause similar symptoms to Bell’s palsy.
What happens if Bell’s palsy is left untreated?
If you experience a severe form of this condition and do not get treatment, it may lead to serious complications (such as permanent facial weakness). That’s why you should immediately seek medical help if weakness or paralysis of the facial muscles. Ask your doctor if you have additional questions.
