BELL'S PALSY

 Basic information

description

Bell's palsy is a paralysis or weakness on one side of the face. The onset may be sudden, or may come on over several days. Bell's palsy involves a cranial nerve and the facial muscles that connect to the nerve. It most often affects people over the age of 13 and occurs more frequently in young adults.

FREQUENT SIGNS & SYMPTOMS

• Sudden paralysis on one side of the face, including muscles to the eyelid.
• Pain in or around the ear on the affected side.
• Numbness on the side of the face.
• Flat, expressionless features on one side of the face.
• Distorted smiles and frowns; drooling.
• Changes in taste, saliva, or tear formation.

causes

Unknown. The paralysis is probably caused by swelling of the facial nerve. The swelling may be caused by a viral infection of the facial nerve as it passes through the temporal bone of the skull.

risk increases with

• Common cold, flu, other upper respiratory infection.
• Pregnancy.
• Diabetes.

PREVENTIVE MEASURES

Cannot be prevented at present.

expected outcomes

• The amount of paralysis determines the extent of recovery. Most patients recover completely with or without treatment.
• Recovery usually begins in 3 weeks and is gradual. Recovery time varies and may take 3 to 6 months.

possible complications

• Eye irritation or injury, because the eye does not close properly and is exposed to dust. If unprotected, the eye may develop ulcers on the cornea.
• Incomplete recovery from paralysis. Results may be slight, mild, or severe.
• Emotional and self-esteem problems.

 diagnosis & treatment

general measures

• Your health care provider will do a physical exam of the affected area. Medical tests such as x-ray may be done to rule out other causes. A nerve study of the facial nerves may be done to determine the extent of nerve damage.
• If you have pain, apply heat to the area twice a day. Use a moist, warm towel and apply for 15 minutes. Cover or close the eye during heat treatments.
• If you cannot wink or close your eye well, you should buy a pair of wrap-around, plastic sports goggles. Wear them to protect your eye from dirt, dust, and dryness.
• At night, apply an eye patch to shut the lid so that the eye stays moist and protected. Sometimes, a patch will be necessary during the daytime.
• As muscle strength returns, use facial massage and exercises. Massage muscles of the forehead, cheek, lips and eyes using cream or oil. Exercise the weak muscles in front of a mirror. Open and close the eye; wink, smile, and bare your teeth. Perform the massage and exercises for 15 to 20 minutes several times a day.
• Brush and floss teeth regularly.
• Surgery on the facial nerve may (rarely) be needed.

medications

• You may be prescribed eye drops for comfort and protection of the exposed eye.
• Antiviral drugs may be prescribed.
• Cortisone drugs may be prescribed to reduce swelling and inflammation of the affected nerve.

activity

Maintain your normal activities.

diet

A soft diet is often necessary.

 notify our office if

• You or a family member has symptoms of Bell's palsy.
• Eye becomes red or irritated, despite treatment.
• Drooling or pain worsens or fever occurs.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.

Special Notes: