DEFINITION Bells palsy is a form of facial paralysis resulting from a dysfunction of the cranial nerve VII (the facial nerve) that results in the inability to control facial muscles on the affected side
INCIDENCE Bells palsy affects about 30,000 - 40,000 people a year in the United States.
ETIOLOGY The cause is often not clear. A type of herpes infection called herpes zoster (herpes zoster) is a painful, blistering skin rash due to the varicella-zoster virus, the virus that causes chickenpox might be involved. Other conditions that may cause Bells palsy include: HIV infection Lyme disease Middle ear infection Sarcoidosis
CLINICAL MANIFESTATIONS A cold is the starting before the symptoms of Bells palsy begin. Symptoms are almost always on one side of the face only. They may range from mild to severe. The face will feel stiff or pulled to one side, and may look different
Contd.. Difficulty in closing one eye Difficulty in eating and drinking; food falls out of one side of the mouth Drooling due to lack of control over the muscles of the face Drooping of the face, such as the eyelid or corner of the mouth Problems in smiling, or making facial expressions Twitching or weakness of the muscles in the face
Other symptoms Dry eye, which may lead to eye sores or infections Dry mouth Headache Loss of sense of taste Sound that is louder in one ear (hyperacusis) Twitching in face
DIAGNOSTIC STUDIES Bells palsy can be diagnosed just by taking a health history and doing a complete physical examination. If it is doubtful that a brain tumor is causing your symptoms, you may need: CT scan of the head Magnetic resonance imaging (MRI) of the head Sometimes, a test to check the nerves that supply the muscles of your face:
CONTD.. Electromyography (EMG) is a test that checks the health of the muscles and the nerves that control the muscles Nerve conduction test Nerve conduction velocity (NCV) is a test to see how fast electrical signals move through a nerve
MEDICAL MANAGEMENT Lubricating eye drops or eye ointments to keep the surface of the eye moist. Advice to wear an eye patch while you sleep. Corticosteroids may reduce swelling around the facial nerve. Antivirals,(such as acyclovir) Mild analgestics to releive pain
Contd.. Physiotherapy can be beneficial to some individuals with Bell’s palsy as it helps to maintain muscle tone of the affected facial muscles and stimulate the facial nerve.
Complications Excess drying of the eye surface, leading to eye sores or infections.
Prevention There is no known way to prevent Bells palsy