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Bell's palsy

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Facial nerves

Alternative Names 
facial nerve weakness, facial nerve palsy, seventh nerve palsy

Definition
Bell's palsy is weakness of the muscles on one side of the face. Rarely it can affect both sides of the face.

What is going on in the body? 
Bell's palsy is thought to be due to inflammation of the seventh cranial nerve. This nerve is called the facial nerve. It tends to come on very suddenly. Some people notice pain behind the ear a day or 2 before they notice any weakness.

What are the signs and symptoms of the disease? 
Symptoms include:
  • a mouth that droops at one corner
  • drooling
  • inability to blink
  • excess or decreased tearing
  • inability to close the eyelid on the affected side
  • difficulty chewing on the affected side
  • decreased sense of taste on the affected side
  • twitching of muscles on the affected side
  • pain or numbness
  • hypersensitivity to sound in the affected ear
  • fear that a stroke has occurred
What are the causes and risks of the disease? 
Bell's palsy is caused by a sudden breakdown or damage to the nerve that supplies the muscles on one side of the face. Attacks often occur without a clear cause. The common cold sore virus, herpes simplex, is the likely cause of many cases of Bell's palsy. Bell's palsy is more common in pregnant women, people recovering from a viral infection, and people with diabetes.

What can be done to prevent the disease? 
Basic wellness methods may help prevent Bell's palsy. This is because the common cold sore virus is often involved. A healthy diet, adequate exercise, and stress management are all important.

How is the disease diagnosed? 
Other disorders, such as stroke and some tumours, can also cause similar symptoms. A doctor can determine if the problem is Bell's palsy based on the specific symptoms.

What are the long-term effects of the disease? 
Many people recover spontaneously. About 70% recover completely within 4 to 6 weeks. About 20% make a partial recovery. Bell's palsy affects only one side of the face at a time. It rarely re-occurs in the same individual.

What are the risks to others? 
Bell's palsy is not spread from human to human contact. The infection causing Bell's palsy may be contagious, though.

What are the treatments for the disease? 
There is no specific treatment for Bell's palsy. It is important that a doctor be consulted immediately. Timely treatment with steroids and pain killers may help. Specific treatments include:
  • patching the eye shut
  • using eye drops to prevent the eye from drying out
  • reassurance from a doctor that this is very common and most people get significantly better within 2 weeks
  • sometimes surgery to restore partial nerve function is performed
What are the side effects of the treatments? 
Preventing eye problems with eye drops and an eye patch is very important. Sometimes eye drops and steroids can have side effects. These should be reported to the doctor.

What happens after treatment for the disease? 
With or without treatment, most people begin to get significantly better in 2 weeks. About 80% recover completely in 3 months.

How is the disease monitored? 
Checking in with a doctor during the period of facial paralysis is important to make sure there are no added complications. This condition can create a lot of anxiety because the appearance of the palsy can look like a stroke.

Author: 
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 19/06/2005
Contributors
Potential conflict of interest information for reviewers available on request
 


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