Bell's Palsy Causes, Symptoms, Diagnosis And Treatment, acute peripheral facial palsy

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

Last Updated: 24th July, 2022

Bell’s palsy is a condition which causes the muscles in the face to become momentarily weak or paralyzed. It can happen once it becomes swollen and distressing, swelled up, or compressed by the nerve that regulates your facial muscles. The disorder causes dropping or becoming stiff on one side of the face.

Bell’s palsy symptoms include abrupt weakness in your facial muscles. The impairment is reversible in most cases and improves substantially over the weeks. The susceptibility makes half your face appear to be dropping. Your facial expression is one-sided, and the side of your eye prevents closing.

Bell’s palsy may affect anyone at any age, often referred to as acute peripheral facial palsy of unknown origin. It is unknown the underlying cause. The effect of inflammation and swelling of the nerve that regulates the muscles on one side of the face is attributed to the effects. Or it may be a consequence that happens after a viral infection.

Acute peripheral facial palsy is reversible for most individuals. Within a few weeks, symptoms usually improve significantly, with full recovery in around six months. A minor percentage of people appear to have permanent manifestations of Bell’s palsy. In rare cases, Bell’s paralysis can reappear.


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What Causes Bell’s Palsy?

Although the exact reason Bell’s palsy occurs isn’t clear, it’s frequently related to experiencing a viral infection. Viruses that have been linked to Bell’s palsy include viruses that cause:

  • Cold sores and genital herpes (Herpes Simplex)
  • Chickenpox and shingles (Herpes Zoster)
  • Infectious mononucleosis (Epstein-Barr)
  • Cytomegalovirus infections
  • Respiratory illnesses (Adenovirus)
  • German measles (Rubella)
  • Mumps (Mumps Virus)
  • The flu (Influenza B)
  • Hand-foot-and-mouth disease (Coxsackievirus)

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The nerve that controls your facial muscle passes through a narrow corridor of bone on its way to your face. In acute peripheral facial palsy, that nerve 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.

Bell’s Palsy Symptoms

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
  • Facial droop and difficulty making facial expressions, like closing your eye or smiling
  • Drooling
  • Pain around the jaw or in or behind your ear on the affected side
  • Increased sensitivity to sound on the affected side
  • A headache
  • A loss of taste
  • Changes in the amount of tears and saliva you produce

In rare cases, Bell’s palsy can affect the nerves on both sides of your face.


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Diagnosis Of Bell’s Palsy

There’s no specific test for Bell’s palsy. Your doctor will look at your face and request you to stimulate your facial muscles by closing your eyes, lifting your brow, showing your teeth and frowning, among other movements.

Other conditions — like a stroke, infections, Lyme disease and tumors — can cause facial muscle weakness that mimics Bell’s palsy. If the cause of your symptoms isn’t clear, 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 nature and speed of the conduction of electrical impulses along a nerve.
  • Imaging Scans. 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, like a tumor or skull fracture.

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Bell’s Palsy Complications

A mild case of Bell’s palsy normally disappears within a month. Recovery from a more severe case involving total paralysis varies. Complications may include:

  • Irreversible damage to your facial nerve.
  • Abnormal regrowth of nerve fibers. This may result 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 clear protective covering of the eye (cornea).

Bell’s Palsy Risk factors

Bell’s palsy occurs more often in people who:

  • Are pregnant, especially during the third trimester or who are in the first week after giving birth
  • Have an upper respiratory infection, like the flu or a cold
  • Have diabetes

Recurrent attacks of Bell’s palsy are rare. But in some of these cases, there’s a family history of recurrent attacks — suggesting a possible genetic predisposition to Bell’s palsy.


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Bell’s Palsy Treatment

Most people with Bell’s palsy recover completely — with or without treatment. There’s no one-size-fits-all treatment for Bell’s palsy, but your doctor may suggest medications or physical therapy to help speed your recovery. Surgery is rarely an option for Bell’s palsy.


Commonly used medications to treat Bell’s palsy include:

  • Corticosteroids, like 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. The role of antivirals remains unsettled. Antivirals alone have shown no benefit compared with a placebo. Antivirals added to steroids are possibly beneficial for some people with Bell’s palsy, but this is still unproved.

However, despite this, valacyclovir (Valtrex) or acyclovir (Zovirax) is sometimes given in combination with prednisone in people with severe facial palsy.


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Physical Therapy

Paralyzed muscles can shrink and shorten, causing permanent contractors. A physical therapist can instruct you how to massage and exercise your facial muscles to help prevent this from occurring.


In the past, decompression surgery was used to relieve the pressure on the facial nerve by revealing the bony passage that the nerve passes through. At present, decompression surgery isn’t recommended. Facial nerve injury and irreversible hearing loss are possible risks associated with this surgery.

Rarely, plastic surgery may be necessitated to correct lasting facial nerve problems. Facial reanimation helps to make the face look more even and may restore facial movement. Examples of this type of surgery include eyebrow lift, eyelid lift, facial implants and nerve grafts. Some procedures, like an eyebrow lift, may need to be repeated after several years.


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Home Remedies

Home treatment may include:

  • Protecting the eye, you can’t close. Using lubricating eye drops during the day and an eye ointment at night will help keep your eye moist. Wearing glasses or goggles during the day and an eye patch at night can screen your eye from getting poked or scratched.
  • Taking over-the-counter pain relievers. Aspirin, ibuprofen (Advil, Motrin IB, others) or acetaminophen (Tylenol, others) may help relieve your pain.
  • Doing your physical therapy exercises. Massaging and exercising your face according to your physical therapist’s advice may help relax your facial muscles.

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Alternative Medicine

Although there’s little scientific evidence to support the use of alternative medicine for people with acute peripheral facial palsy, some people with the condition may benefit from the following:

  • Acupuncture. Placing thin needles into a specific point in your skin helps stimulate nerves and muscles, which may offer some relief.
  • Biofeedback Training. By advising you to use your thoughts to manipulate your body, biofeedback training may aid you gain better control over your facial muscles.

Final Words
Seek urgent 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, but it can cause similar symptoms. Consult your doctor if you experience facial weakness or drooping to find out the underlying cause and severity of the illness.

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