In the early 19th century, a surgeon hailing from Scotland described the functions of facial nerves and the conditions that could particularly inhibit their proper functioning. Sir Bell contrasted the condition with stroke as the former is the main contributor towards facial paralysis, commonly affecting a pair of the nerves surrounding the region. The disease is what we now know as Bell’s palsy.
Bell’s palsy is a condition that causes paralysis in the face region by damaging the nerves surrounding it. The facial nerves are known by their medical name 7th cranial nerve passing through the fallopian canal in the ear then reaching each side of the face. Each nerve is in charge of performing a certain function like blinking, facial expressions, smiling or frowning. Interestingly, the act of crying is also carried out by these nerves which transmit impulses to the lacrimal (tear) glands.
The patient suffering from Bell’s palsy will have damaged these very nerves which in turn disrupt the normal working procedure of the face region. The brain is unable to transmit impulses, as a result, causing paralysis. The disease can affect anyone in the age group between 18 to 60.
Bell’s palsy usually sets in when one has experienced severe cold, ear/eye infection, the signs appearing two weeks after. The reason why the condition becomes entirely difficult to detect in the initial stages is that the symptoms of Bell’s palsy appear abruptly. Surgeons have reported cases where patient woke up in the morning unable to feel sensation in the face region despite the normal workings of the nerves a day earlier. Thereby, the only preventive measure one can take is to be cautious enough to seek professional advice if a cold or fever is known to have prolonged more than usual.
One way to characterize Bell’s palsy is to notice for the limping of one side of the face. As a consequence of it, person finds it difficult or impossible at times to speak properly and open his/her eyes. Although, the condition affects both sides of the face is uncommon, there have been reported cases in the USA in the last decade.
Other symptoms of Bell’s palsy include:
- Dryness in the eyes and mouth
- A headache
- Inhibition of facial expressions
- Unable to eat due to difficulty in chewing
- Eye irritation
The best way to recognize any disease is to look for the symptoms, however, surgeons advise otherwise for Bell’s palsy. The signs of the condition happen to be very similar to a brain tumour and stroke thereby one should not self-diagnose without consulting a professional first.
Studies are being carried out to examine the causes of Bell’s palsy yet the medical science field awaits a final conclusion. Though a number of hypotheses have been put forward as probable causes, scientists most likely believe that the condition is caused by viral infections. Following are the bacteria and viruses that can possibly trigger the development of facial paralysis:
- .Sarcoidosis: Responsible for inflammation in the organs forming clumps
- Herpes Simplex: Also known as HSV, this category of virus causes blistering sores in the mouth or genital regions. It is known to be contagious and through direct contact can pass from one person to the other
- HIV: The HIV virus damages the immune system inhibiting most of its functions. HIV attacks CD-4 Cells that are responsible for protecting the body against foreign invading cells. Currently, there is no discovered treatment for HIV caused illnesses.
- Lyme Disease: Caused by the bacteria Borrelia burgdorferi sensu. The stage 2 of the condition has symptoms including Bell’s Palsy. It results when the bacteria is allowed to exist in the body for two weeks after the first bite.
When any of the above-mentioned bacteria/ virus is known to reside, complications can occur which may eventually lead to Bell’s palsy condition. The condition causes the damage to the 7th cranial facial nerve, as mentioned earlier.
Medical surgeons have been able to identify certain groups of people who are more vulnerable to this disease than other people. Pregnant women, diabetics and patients with pulmonary infections amplify their chances of developing Bell’s palsy. Moreover, family history is one other factor that comes into play if one has ancestral roots who suffered from this condition.
One interesting fact about Bell’s Palsy is that the compression of 7th cranial nerve on the right side of the face will cause paralysis in the opposite side!
Diagnosis of Bell’s Palsy can be hard due to the fact that the drooping of the face and other symptoms are abrupt that may not be present earlier. In the first instance, it is imperative to consider the issue of prolonged flu and fever as the condition develops post the second week.
Any medical professional who deals with Bell’s palsy will conduct few physical examinations to determine the extent of the symptoms and the presence of virus causing it. The physical examinations will also conclude whether the limping of the facial region is caused due to the brain tumor or is temporary paralysis as caused by this condition. Following tests may be performed to arrive at a more accurate decision:
- Electromyography: This test measures the electrical activity of the muscles by judging their responsivity to nerve transmissions. The nature and speed of the transmissions can be judged through EMG as well as any nerve damage that has or had taken place
- MRI: Magnetic Resonance Imaging is a way to determine how healthy the brain tissues are and the presence of any tumours and infection that may be the cause of face paralysis
However, it is pertinent to know that no one test can directly tell the presence of this disease.
Treatment and Prognosis:
Bell’s Palsy can be treated through physical therapy or medications. Fortunately, patients recover fully from this condition and are able to continue with their normal lifestyle. There have been instances where no treatment was sought, and the prognosis was achieved. Yet one should always consider professional advice as the symptoms can signify the presence of other terminal illnesses.
Bell’s palsy may be treated with two commonly prescribed synthetic drugs. According to Mayo Clinic, Corticosteroids have anti-inflammatory properties that may lessen the swelling of the face. For optimizing the results, should be used (after consultation with a medical professional) within the first few days when the symptoms appear.
Most of the Anti-Viral Drugs can inhibit the damage caused by the virus existing in the facial regions. However, the final results are still not confirmed and antiviral drugs can work best when taken with steroids.
Physical therapies take into account both the home-based remedies and the surgical method of treating Bell’s Palsy. The home based remedies as instructed by physiotherapist would entail massaging and exercising of facial muscles that can lessen the swelling. The remedy can be used as a precautionary practice too.
The surgical method involves decompression. The bony passage where the nerve is contained, is opened and decompressed to release the excessive pressure. There are a lot of risks involved with this technique. People who undertook this surgery though were able to recover fully reported loss of hearing along with other complications. The failure of this surgical method can result in permanent damage to the facial nerve.