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Mohammed A Qazzaz
Bell's palsy causes sudden weakness
in your facial muscles. This makes
half of your face appear to droop.
Your smile is one-sided, and your eye
on that side resists closing.
The exact cause is unknown, but it's
believed to be the result of swelling
and inflammation of the nerve that
controls the muscles on one side of
your face. It may be a reaction that
occurs after a viral infection.
Bell's palsy is temporary. Symptoms
usually start to improve within a few
weeks, with complete recovery in
about six months. sometimes it
continue to have Bell's palsy
symptoms for life. Rarely, Bell's palsy
can recur.
Right side
facial palsy
Although the exact reason Bell's
palsy occurs isn't clear, it's often
linked to exposure to a viral
infection.
 Cold sores and genital herpes (herpes simplex)
 Chickenpox and shingles (herpes zoster)
 Mononucleosis (Epstein-Barr)
 Cytomegalovirus infections
 Respiratory illnesses (adenovirus)
 German measles (rubella)
 Mumps (mumps virus)
 Flu (influenza B)
 Hand-foot-and-mouth disease (coxsackievirus)
With Bell's palsy, the nerve that
controls your facial muscles, which
passes through a narrow corridor of
bone on its way to your face, becomes
inflamed and swollen — usually related
to a viral infection. Besides facial
muscles, the nerve affects tears, saliva,
taste and a small bone in the middle of
your ear.
Facial nerve
anatomy
Signs and symptoms of Bell's palsy come on
suddenly, and may include:
• Rapid onset of mild weakness to total paralysis on one
side of your face — occurring within hours to days —
making it difficult to smile or close your eye on the
affected side
• Facial droop and difficulty making facial expressions
• Pain around the jaw or in or behind your ear on the
affected side
• Increased sensitivity to sound on the affected side
• Headache
• A decrease in your ability to taste
• Changes in the amount of tears and saliva you produce
Signs and
symptoms
In rare cases, Bell's palsy
can affect the nerves on
both sides of your face
When to see a doctor.
Seek immediate medical help if
you experience any type of
paralysis because you may be
having a stroke. Bell's palsy is not
caused by a stroke. See your
doctor if you experience facial
weakness or drooping, to
determine the underlying cause
and severity of the illness.
There's no specific test for Bell's palsy. Your
doctor will look at your face and ask you to
move your facial muscles by closing your
eyes, lifting your brow, showing your teeth
and frowning, among other movements.
Test and diagnosis.
Other conditions — such as a stroke,
infections, Lyme disease and tumors — can
also cause facial muscle weakness,
mimicking Bell's palsy. If it's not clear why
you're having the symptoms you are
your doctor may recommend other tests,
including:
Electromyography (EMG). This test can confirm the
presence of nerve damage and determine its severity. An
EMG measures the electrical activity of a muscle in
response to stimulation and the nature and speed of the
conduction of electrical impulses along a nerve.
Imaging scans. X-ray imaging, magnetic resonance imaging
(MRI) or computerized tomography (CT) may be needed on
occasion to rule out other possible sources of pressure on
the facial nerve, such as a tumor or skull fracture.
Although a mild case of Bell's palsy normally disappears
within a month, recovery from a case involving total
paralysis varies. Complications may include:
• Irreversible damage to your facial nerve
• Misdirected regrowth of nerve fibers, resulting in
involuntary contraction of certain muscles when
you're trying to move others (synkinesis) — for
example, when you smile, the eye on the affected side
may close
• Partial or complete blindness of the eye that won't
close, due to excessive dryness and scratching of the
cornea, the clear protective covering of the eye
Complications
Medications :
Commonly used medications to treat Bell's palsy include:
• Corticosteroids, such as prednisone, are powerful anti-
inflammatory agents. If they can reduce the swelling of
the facial nerve, it will fit more comfortably within the
bony corridor that surrounds it. Corticosteroids may
work best if they're started within several days of when
your symptoms started.
• Antiviral drugs, such as acyclovir (Zovirax) or
valacyclovir (Valtrex), may stop the progression of the
infection if a virus is known to have caused it. This
treatment may be offered only if your facial paralysis is
severe.
Physical therapy
Paralyzed muscles can shrink
and shorten, causing
permanent contractures. A
physical therapist can teach
you how to massage and
exercise your facial muscles
to help prevent this from
occurring.
Surgery
In the past, decompression surgery was used
to relieve the pressure on the facial nerve by
opening the bony passage that the nerve
passes through. Today, decompression surgery
isn't recommended. Facial nerve injury and
permanent hearing loss are possible risks
associated with this surgery.
In rare cases, plastic surgery may be needed to
correct lasting facial nerve problems.
Bell's palsy

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Bell's palsy

  • 2. Bell's palsy causes sudden weakness in your facial muscles. This makes half of your face appear to droop. Your smile is one-sided, and your eye on that side resists closing.
  • 3. The exact cause is unknown, but it's believed to be the result of swelling and inflammation of the nerve that controls the muscles on one side of your face. It may be a reaction that occurs after a viral infection.
  • 4. Bell's palsy is temporary. Symptoms usually start to improve within a few weeks, with complete recovery in about six months. sometimes it continue to have Bell's palsy symptoms for life. Rarely, Bell's palsy can recur.
  • 6. Although the exact reason Bell's palsy occurs isn't clear, it's often linked to exposure to a viral infection.
  • 7.  Cold sores and genital herpes (herpes simplex)  Chickenpox and shingles (herpes zoster)  Mononucleosis (Epstein-Barr)  Cytomegalovirus infections  Respiratory illnesses (adenovirus)  German measles (rubella)  Mumps (mumps virus)  Flu (influenza B)  Hand-foot-and-mouth disease (coxsackievirus)
  • 8. With Bell's palsy, the nerve that controls your facial muscles, which passes through a narrow corridor of bone on its way to your face, becomes inflamed and swollen — usually related to a viral infection. Besides facial muscles, the nerve affects tears, saliva, taste and a small bone in the middle of your ear.
  • 10.
  • 11. Signs and symptoms of Bell's palsy come on suddenly, and may include: • Rapid onset of mild weakness to total paralysis on one side of your face — occurring within hours to days — making it difficult to smile or close your eye on the affected side • Facial droop and difficulty making facial expressions • Pain around the jaw or in or behind your ear on the affected side • Increased sensitivity to sound on the affected side • Headache • A decrease in your ability to taste • Changes in the amount of tears and saliva you produce
  • 13. In rare cases, Bell's palsy can affect the nerves on both sides of your face
  • 14. When to see a doctor. Seek immediate medical help if you experience any type of paralysis because you may be having a stroke. Bell's palsy is not caused by a stroke. See your doctor if you experience facial weakness or drooping, to determine the underlying cause and severity of the illness.
  • 15. There's no specific test for Bell's palsy. Your doctor will look at your face and ask you to move your facial muscles by closing your eyes, lifting your brow, showing your teeth and frowning, among other movements. Test and diagnosis.
  • 16. Other conditions — such as a stroke, infections, Lyme disease and tumors — can also cause facial muscle weakness, mimicking Bell's palsy. If it's not clear why you're having the symptoms you are
  • 17. your doctor may recommend other tests, including: Electromyography (EMG). This test can confirm the presence of nerve damage and determine its severity. An EMG measures the electrical activity of a muscle in response to stimulation and the nature and speed of the conduction of electrical impulses along a nerve. Imaging scans. X-ray imaging, magnetic resonance imaging (MRI) or computerized tomography (CT) may be needed on occasion to rule out other possible sources of pressure on the facial nerve, such as a tumor or skull fracture.
  • 18. Although a mild case of Bell's palsy normally disappears within a month, recovery from a case involving total paralysis varies. Complications may include: • Irreversible damage to your facial nerve • Misdirected regrowth of nerve fibers, resulting in involuntary contraction of certain muscles when you're trying to move others (synkinesis) — for example, when you smile, the eye on the affected side may close • Partial or complete blindness of the eye that won't close, due to excessive dryness and scratching of the cornea, the clear protective covering of the eye Complications
  • 19. Medications : Commonly used medications to treat Bell's palsy include: • Corticosteroids, such as prednisone, are powerful anti- inflammatory agents. If they can reduce the swelling of the facial nerve, it will fit more comfortably within the bony corridor that surrounds it. Corticosteroids may work best if they're started within several days of when your symptoms started.
  • 20. • Antiviral drugs, such as acyclovir (Zovirax) or valacyclovir (Valtrex), may stop the progression of the infection if a virus is known to have caused it. This treatment may be offered only if your facial paralysis is severe.
  • 21. Physical therapy Paralyzed muscles can shrink and shorten, causing permanent contractures. A physical therapist can teach you how to massage and exercise your facial muscles to help prevent this from occurring.
  • 22. Surgery In the past, decompression surgery was used to relieve the pressure on the facial nerve by opening the bony passage that the nerve passes through. Today, decompression surgery isn't recommended. Facial nerve injury and permanent hearing loss are possible risks associated with this surgery. In rare cases, plastic surgery may be needed to correct lasting facial nerve problems.