Bell’s Palsy: Symptoms, Causes, Diagnosis, Treatment!

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

  1. Bell’s Palsy is diagnosed by determination & exclusion of diseases that may cause the similar symptoms.
  2. Degree of nerve damage can be assessed by tallying against the House-Brackmann score.
  3. Electromyography (EMG) is a test done to measure the degree of nerve damage, similarly the response of the nerve to stimulation & the electrical response.
  4. 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.