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Bell's palsy

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Bell's palsy

What is Bell's palsy?

Bell's palsy is a disorder that affects nerves and muscles in the face causing paralysis or drooping of one side of the face. Most people who experience the condition are concerned about the unsightly unbalanced look it gives to their face but fortunately such imbalance resolves completely in most cases.

Bell's palsy can affect the ability to eat and drink, and it can be difficult to form normal facial expressions. If the face is mostly or fully paralysed, there may be a difficulty with closing one eye, which can leave the eye vulnerable and exposed particularly during sleep. Some sufferers may experience episodes of drooling from the side of the mouth. Bell's palsy may also be accompanied by a sensitivity to sound on the affected side. Some people experience headache and in particular may experience pain in the head just behind the ear on the affected side. This is often the first symptom of an incipient Bell’s palsy.

Many of these symptoms cause great embarrassment to the sufferer and being the recipient of stares from strangers can also be an unpleasant experience.

What causes it to happen?

Bell's palsy is an acute form of cranial neuropathy. This means that it involves damage to a single nerve, in this case the seventh cranial, or facial, nerve. This is the nerve that controls the movement of muscles of facial expression. The cause is unknown, but it affects between 1 in 5,000 and 1 in 1,000 people, according to various estimates. In 75% of cases, the palsy is preceded by an upper respiratory infection. The condition has also been associated with head injuries, heart attacks and hypertension.

How can it be treated?

Generally, the condition is not treated, as in most cases it simply resolves itself. However, some cases do result in permanent facial changes. A patient who experiences Bell's palsy may require treatment for some of the symptoms that the paralysis can cause.

Treatment for BellŐs palsy is likely to undergo change in the light of recent trial results. It has been reported that antiviral drugs can have a beneficial effect if given in the early stages of an evolving BellŐs palsy. Up to very recent times it was customary for steroids to be used, which had to be administered in the early stages of the condition if they were to be effective.These recent trial results are likely to supplant the use of steroids.

No matter what treatment is given special attention needs to be given to the eyes. If one eye cannot be completely closed, a doctor might prescribe eye drops to keep it lubricated. It is also recommended that the eye be taped shut at night. This is simply done by applying one end of a short piece of dressing tape to the upper eyelid and applying the other end below the lower eyelid.

Physiotherapy can be helpful in some cases but is usually not initiated for a couple of weeks after initial onset. Earlier intervention has not proven to be of any benefit. Surgery is not recommended for people with Bell's palsy, as surgical decompression of the nerve does not appear to offer any benefit.

When will it go away?

In 60% to 80% of cases the condition resolves itself within a few weeks to a few months. In a minority of cases, there will be permanent disfigurement. It is important to attend your doctor as soon as any facial paralysis occurs in order to establish a precise diagnosis.

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