Bell’s palsy is a type of facial paralysis that results in an inability to control the facial muscles on the affected side. There can be a variety of symptoms present like twitching of the muscles, drooling, pain around the ear, etc.
SIGNS & SYMPTOMS
- One sided facial drooping, within 72 hours.
- In rare cases it can manifest on both the sides.
- Loss of taste
- Drooling
- Tears from the eyelids which are not in your control
- Pain behind the ear & jaw
- Sound sensitivity
- Distortion in hearing the sounds.
- Moderate or severe headache
- Tingling of the facial muscles
- Memory problems
- Problems in balance of the body.
CAUSES & RISK FACTORS FOR BELL’S PALSY
- Bell’s palsy occurs due to a malfunction of the facial nerve (cranial nerve VII), which controls the muscles of the face.
- Inflammation or injury of this nerve is considered to cause damage & losing control of its functions.
- Particular cause is unknown, although there are several risk factors;
- Diabetes
- Upper respiratory tract infection
- Diabetes
- Cold sores of genital herpes
- Chickenpox & shingles
- Infection by EBV
- German measles
- Mumps
- Influenza-B
- Genetic factors
- Migraines
COMPLICATIONS
- Chronic loss of taste
- Chronic loss of ability to control facial expression/damage to facial nerve
- Facial spasm
- Facial pain
- Corneal infections
- Syskinesia, a condition in which the voluntary movement of one muscle, causes the involuntary movement of other muscles, surrounding it.
- For Eg; when a person closes the eye, the corner of the mouth lifts involuntarily.
- Damage to hearing & tinnitus, ringing in the ear.
- Faulty & involuntary tears while eating.
DIAGNOSIS FOR BELL’S PALSY
- Bell’s Palsy is diagnosed by determination & exclusion of diseases that may cause the similar symptoms.
- Degree of nerve damage can be assessed by tallying against the House-Brackmann score.
- Electromyography (EMG) is a test done to measure the degree of nerve damage, similarly the response of the nerve to stimulation & the electrical response.
- MRI or CT scan may be done for differential diagnosis & assessing extent of nerve damage.
DIFFERENTIAL DIAGNOSIS
- Herpes zoster infection
- Herpes Simplex infection
- Lyme Disease
- Sarcoidosis
- Stroke
- Ramsay Hunt Syndrome Type 2
- Brain tumor
- Diabetes
- Head trauma
- Meningitis
- Acute HIV
- Brucellosis
- Myasthenia Gravis
TREATMENT & MANAGEMENT OF BELL’S PALSY
- Corticosteroids have shown a promise for recovery in 6 months.
- Antivirals in combination therapy with Corticosteroids
- Facial surgery or surgery to relieve pressure from the nerve is done.
- Because of the condition & the impact on the eyes, lubricating eyedrops & patches are used for relief.
- OTC pain medicines, therefore provide relief to the pain caused because of the condition.
- Acupuncture have shown a little evidence in relieving the symptoms of Bell’s Palsy.
- Physiotherapy is done to relax the facial muscles & relieve symptoms.