Bells Palsy

Bell's Palsy is the paralysis or severe weakness of the nerve that controls the facial muscles on the side of the face - the facial nerve or seventh cranial nerve. Patients typically find they suddenly cannot control their facial muscles, usually on one side. A person might have Bell's Palsy first thing in the morning they wake up and find that one side of the face does not move. If an eyelid is affected, blinking might be difficult. Bell's Palsy usually starts suddenly and must not be confused with cerebral palsy, a completely different condition. Most people who suddenly experience symptoms think they are having a stroke. However, if the weakness or paralysis only affects the face it is more likely to be Bell's palsy.

In Israel according to statistics from 82.5% population, 22.75% is suffering by diseases and people death rate due to Bell's Palsy is about 7.44%. The facial nerves control blinking, opening and closing of the eyes, smiling, salivation, lacrimation (production of tears) and frowning. They also supply the stapes muscles with nerves. The stapes is a bone in the ear which is involved in our ability to hear. When the facial muscle malfunctions, the following symptoms may emerge symptoms of Bell's palsy. There may be a sudden paralysis/weakness in one side of face. It makes difficult to close one of the eyelids, irritates and changes amount of tears. Parts of the face may droop, such as one side of the mouth drooling and from other side of the mouth, amount of saliva production changes. Difficulty with facial expressions, sense of taste may become altered. An affected ear may lead to sensitivity to sound (hyperacusis). Sounds seem louder. Pain in front or behind the ear on the affected side. It may also cause some headache.

The facial nerve controls most of the muscles in the face and parts of the ear. The facial nerve goes through a narrow gap of bone from the brain to the face. This nerve becomes inflamed. It is most likely caused by a virus, usually the herpes virus, which inflames the nerve. The herpes virus is the one that also causes cold sores and genital herpes. Other viruses have also been linked to Bell's palsy, including the chickenpox and shingles viruses, which are both related to the herpes virus. The virus that causes mononucleosis (Epstein-Barr) as well as the cytomegalovirus has also been linked to Bell's palsy. Lyme disease in areas where it is endemic may be a principal cause of Bell's palsy type symptoms caused by bacteria. If the nerve is inflamed it will press against the cheekbone or may pinch in the tight corridor (narrow gap of bone) - this can result in damage to the protective covering of the nerve. If the protective covering of the nerve becomes damaged, the signals which are being sent from the brain to the muscles in the face may not be transmitted properly, leading to weakened or paralyzed facial muscles. They can be cured through therapies such as Mime therapy, Plastic surgery, Botox. There may be a complications expected as misdirected re-growth of nerve fibers, Ageusia, Gustatolacrimal reflex, corneal ulceration.

Most people who have Bell's palsy recover completely, without treatment, in 1 to 2 months. This is especially true for people who can still partly move their facial muscles. But a small number of people may have permanent muscle weakness or other problems on the affected side of the face. Treatment with corticosteroid medicines (such as prednisone) can make it more likely that you will regain all facial movement. They work best if they are taken soon after symptoms start (within 3 days). Sometimes antiviral medicines (such as acyclovir) may be added to corticosteroid medicines to treat Bell's palsy. But evidence for using antiviral medicines is weak. They may help in some cases, but in general they do not affect recovery. Some people may not be able to take corticosteroid medicines because of other health problems. It's important to remember that most people with Bell's palsy recover completely without any treatment.