Bell’s palsy : pathophysiology of the facial paralysis causing disease

Bell’s Palsy : Pathophysiology Of The Facial Paralysis Causing Disease
Reviewed by: Livlong
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Bell palsy is an unexplained episode of facial muscle weakness or paralysis. It begins suddenly and can get worse over 48 hours. This condition results from damage to the facial nerve (the 7th cranial nerve). Pain and discomfort usually occur on one side of the face or head. 

It is a condition that affects the muscles on one side of the face. It causes temporary paralysis. 

The aim of this article is to explain to the reader what exactly is Bell’s palsy. It will also give an idea about its causes, diagnoses, symptoms and options for treatment. 

Case Study: Paul, a 35-year-old man woke up one day and realized that he was unable to move the left side of his face. He thought he was having a stroke. A doctor’s visit diagnosed him with Bell’s palsy. His diagnosis was just a mild facial paralysis. The doctors prescribed him some medication along with facial exercises. In a matter of 3 months, he regained about 90% of his facial movements. 

What Is Bell's Palsy?

This condition occurs when a facial nerve, called the seventh cranial nerve is damaged or inflamed. This results in temporary paralysis or weakness of the muscles on one side of the face. This particular nerve is supposed to be responsible for controlling all facial muscles such as blinking, smiling and even talking. 

Bell's Palsy Causes

The cause of Bell palsy is not known. It may be due to inflammation that is directed by the body's immune system against the nerve controlling movement of the face. Bell palsy is sometimes linked to the following: 
  • Diabetes 
  • High blood pressure 
  • Toxins 
  • Lyme disease 
  • Guillain-Barré syndrome 
  • Sarcoidosis
  • Infection, especially following a viral infection with Herpes simplex virus. This is a virus that is related to the cause of the common "cold sores" of the mouth. 
This condition is not permanent. Most people diagnosed with Bell’s Palsy recover fully over time. 

Bell's Palsy Symptoms

The symptoms for Bell’s Palsy usually appear suddenly. They can range from mild symptoms to very severe symptoms. Some of the common symptoms are listed below: 
  • Disordered movement of the muscles that control facial expressions, such as smiling, squinting, blinking, or closing the eyelid 
  • Sudden weakness or paralysis on one side of the face. 
  • Mouth or eyelid drooping 
  • Headache 
  • Tearing 
  • Drooling 
  • Loss of the sense of taste on the front 2/3 of the tongue 
  • Hypersensitivity to sound in the affected ear (hyperacusis) 
  • Inability to close the eye on the affected side of the face 
  • Dryness of the eye or mouth on the affected side of the face
Most of these symptoms are similar to stroke and so people usually panic and get worried. However, it must be noted that Bell’s Palsy is a condition that only affects the face. It is not life-threatening. 

Bell's Palsy Diagnosis

If you experience any one of the symptoms listed above it is very important to immediately visit a doctor and get a proper diagnosis. 

A Bell's Palsy diagnosis often involves: 

  • Checking facial muscle movements. 
  • Electromyography to determine the extent of the nerve involvement 
  • Blood tests to determine if another condition, such as diabetes or Lyme disease, is present 
  • MRI or CT scan to find out if there is a structural cause for your symptoms 

Bell's Palsy Treatment

Most people that are diagnosed with this condition are often known to recover without much treatment. Early diagnosis can prevent permanent loss of movement of facial muscles and speed up the recovery process. 

The following are some common Bell’s palsy treatment options: 

Bell's Palsy Medication

Corticosteroids: If this medication is taken within 72 hours of the attack, it is very effective. It reduces the inflammation of the facial nerve. 

Antiviral medications: These drugs are prescribed alongside other steroids when they suspect a virus present. 

Bell's Palsy Physical Therapies

Physical therapy and facial exercises: Different forms of facial exercises are taught to the patient. This further helps in preventing stiffness of the muscles and improves their movement over time. 

Facial Exercises for Bell's Palsy

A very important part of the recovery process is the exercises of facial muscles. These exercises help in improving the strength and coordination of the facial muscles. 

Here’s a list of some common facial exercises: 

Eyebrow lifts: Lifting the eyebrows as high as possible and holding it there for a few seconds. 

Eye closure exercises: Closing the affected eye and suddenly opening it wide. Repeat this a few times. 

Smile training: One must practice to smile and holding it for a few seconds. It may be difficult at first but is very effective. 

Also Read : Face Yoga: The Science of Softening and Relaxing Your Face

Bell's Palsy : When to See a Doctor

It is known that Bell’s Palsy symptoms usually improve and get better within a few weeks. However, there are certain situations where one must immediately go see a doctor: 
  • If the symptoms remain the same and do not improve even after two weeks.
  • If the symptoms are developed on both sides of the face. 
  • If the affected eye cannot close properly. This will often lead to dryness and certain vision problems too. 
  • If there is any pain or a loss of sensation in any other part of the body. 
References:
  1. Bell's Palsy. NIH - National Institute of Neurological Disorders and Stroke [Internet]. https://www.ninds.nih.gov/health-information/disorders/bells-palsy. Accessed Oct. 01, 2024.
  2. What is Bell's Palsy?. Penn Medicine [Internet]. https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/bells-palsy. Accessed Oct. 04, 2024.
  3. What Is Bell's Palsy?. American Academy of Ophthalmology[Internet]. https://www.aao.org/eye-health/diseases/bells-palsy. Accessed Oct. 3, 2024.
  4. Bell's Palsy. NORD – National Organization for Rare Disorders[Internet].  https://rarediseases.org/rare-diseases/bells-palsy/. Accessed Oct. 5, 2024.
  5. What to know about Bell's palsy. MedicalNewsToday[Internet]. https://www.medicalnewstoday.com/articles/158863. Accessed Oct. 05, 2024

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LivLong - About the Author

Livlong 365 is a trusted digital healthcare platform committed to making quality health and wellness services accessible, affordable, and user-friendly for every Indian. Through our informative and educational blogs, we aim to empower individuals with accurate health knowledge, preventive care tips, and expert-backed insights to help them lead healthier, more informed lives.

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