What is Bell’s palsy?
Bell’s palsy is a weakness or paralysis of a facial nerve. There is a facial nerve on each side of the face. The facial nerves control movement of the muscles of expression. When one of the nerves is weak or paralyzed, that side of the face droops and it may be hard to smile. You may also have trouble closing the eye on that side.
How does it occur?
The cause of Bell’s palsy is not known. A common theory is that a virus may make the nerve swell. The nerve is then squeezed against the boney canal it passes through from the brain to the muscles of the face. When this happens, the nerve can no longer control the facial muscles. The muscles become weak or paralyzed and you lose part or all control of the muscles.
What are the symptoms?
The first symptom may be an ache behind the ear on the side of your face that is affected. Then that side of your face will become weak or paralyzed. The paralysis usually starts in the lower part of the face.
Other possible symptoms are:
· Watery eye
· One eye won’t close completely
· Decreased taste
· A change in hearing
· Trouble smiling with one side of your mouth
· Trouble drinking or chewing
· slurring your words when you talk
The severity of Bell’s palsy can vary from a mild weakness to complete paralysis of one side of the face.
Symptoms may develop within a few hours or over a couple of days. The faster the symptoms happen, the more severe the weakness or paralysis is likely to be.
See your healthcare provider right away if your symptoms develop quickly, for example, in 30 to 60 minutes. Your provider will want to make sure that you are not having a stroke. Long term damage or death from a stroke may be prevented if the stroke is treated within the first 3 hours after you start having symptoms.
How is it diagnosed?
Your healthcare provider will ask about your symptoms and examine you. Your provider will need to make sure that something else isn’t causing your symptoms, such as an injury, stroke, or tumor. You may have a hearing test or brain scan. Electrical testing of the facial nerve may be done to see how much the nerve is damaged.
How is it treated?
Your provider will prescribe steroid medicine, such as prednisone. Antiviral medicine, such as acyclovir, may also be prescribed. The 2 medicines taken together may do a better job of preventing permanent effects.
Using a steroid for a long time can have serious side effects. Take steroid medicine exactly as your healthcare provider prescribes. Don’t take more or less of it than prescribed by your provider and don’t take it longer than prescribed. Don’t stop taking a steroid without your provider’s approval. You may have to lower your dosage slowly before stopping it.
Physical therapy, including exercises and massage, may help you keep some muscle strength and flexibility as you wait for the symptoms to go away
Rarely, when the paralysis is severe, surgery may be done to try to relieve pressure on the nerve.
If the eye on the affected side does not close completely, it needs to be protected from problems such as dust and getting to dry. Patching the eye or using eye drops or eye ointments can protect the eye. If the eye is not protected, you could lose vision in that eye.
How long will the effects last?
If you have at least some muscle movement while you have Bell’s palsy, you have a good chance for a complete recovery. If you have complete paralysis–that is, no movement of the facial muscles at all–you will probably not get back full muscle movement.
Even mild cases of Bell’s palsy can last several weeks. It may be months before you know how much muscle control you will recover.
It’s rare to have Bell’s palsy more than once. If you have facial paralysis again, another problem may be causing it and you should get it checked right away by your healthcare provider.
How can I help take care of myself?
Acetaminophen or nonprescription anti-inflammatory medicine (NSAIDs) such as ibuprofen or naproxen may help decrease your pain. NSAIDs may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take NSAIDs for more than 10 days for any reason.
Relaxation techniques, acupuncture, electrical stimulation, or biofeedback training may help. Ask your healthcare provider about your particular situation.
Gentle facial massage may help you get back more muscle movement as you recover.
Mild heat or cold packs used for 15 to 20 minutes 3 to 4 times a day may also help lessen discomfort. Never put ice directly on your skin. This could cause frostbite to the area.
If your eye is not closing completely, keep it moist. Some things that might help your eye from becoming too dry are:
· Use artificial tears when you are awake to replace normal moisture in the eye.
· Use eye lubricant ointment when you are sleeping. The ointment may be used also when you are awake if artificial tears don’t give enough protection. However, the ointment may temporarily blur your vision.
· Wear eyeglasses or a shield to protect the eye. Wear eyeglasses with tinted lenses or sunglasses when you are in direct sunlight.
· Take extra care to keep your eye moist when you are working on a computer. People tend to blink less often while at a computer. If your eye is dry and not blinking completely, this can be more of a problem. Keep eye drops handy. You can also use the back of your index finger to blink your eye manually.
· Food particles can lodge between the gum and cheek, so be especially careful to clean your teeth, gums, and mouth.
· Get a lot of rest.