Bell's Palsy

Bell's Palsy Introduction person might wake up one morning and discover that one side of his or her face shows signs of paralysis. The symmetrical nature of the face might have a mismatched appearance. The afflicted side may have varying levels of deformity and droopiness. The person might discover the inability to close the eye. The paralysis of one side of the face means that speech is often distorted. Feeding is difficult. Drooling is frequent.

The person finds it impossible to pucker the lips into a shape that is often used for whistling. The direct diagnosis is that this person is suffering from Bell's Palsy. This condition is relatively temporary. Only few people who suffer from this condition have permanent effects. Bell's Palsy can develop over a few hours or a few days. It is not uncommon for a person to find that the condition has developed overnight. Origins Sr. Charles Bell a Scottish Physician first described the condition in the 19th century.

The paralysis from Bell's Palsy often leaves the afflicted fearing that they have suffered a stroke. This is not true. Bell's Palsy occurs from damage to the facial nerves. The nerves are disrupted and typical stimuli are interrupted or distorted. The brain does not process the disrupted information well. This leads to paralysis. Since the damage occurs to one of the pair of facial nerves, the paralysis and other symptoms occurs only on one side of the face. This is side where the nerve suffers damage.

There is no preference for the left or right side. The chances of the condition affecting both sides of the face are rare. Causes and Epidemiology The causes of Bell's Palsy have not been directly identified. Causes are associated with anything that might cause damage to the nerves. Inflammation in the area of the nerves is often the cause. This might be caused by infections from the common cold virus -- herpes simplex. Some researchers have even pointed to herpes meningitis.

The inflammation causes pressure on the Fallopian canal (a bony conduit that covers most of the facial nerve). This damages the nerves. Other times, pressure on the nerves disrupts the flow of oxygen and blood in the area. Diabetics are particularly susceptible to the condition -- almost four times as much as non-diabetics. High blood pressure, meningitis, mechanical injuries to the face and head, a middle ear infection that lasts for a long time, headaches are implicated in causing Bell's Palsy.

People who have had an influenza or a cold are more susceptible than others. It is said that approximately twenty-five in one hundred thousand people will suffer from Bell's Palsy. The condition does not discriminate based on sex. Women are as likely as men to suffer from it. Pregnant women, especially in the third trimester are particularly susceptible to the condition. (Singhi and Jain, 2003) and elderly above the age of sixty.

The National Institute of Neurological Disorders and Stroke (NINDS), a branch of the National Institute for Health reports that there might be a genetic susceptibility to Bell's Palsy. (NINDS, 2004) Those suffering from inflammation diseases such as sarcoidosis or disease of the immune system such as HIV are also at greater risk for Bell's Palsy. Though there is no specific cure for the condition and most medications treat the symptoms, the prognosis for Bell's Palsy is positive. Recovery takes as long as it takes for the facial nerve to heal.

Most patients fully recover in a few weeks. Signs of recovery often are as early as one or two weeks. Sometimes, recovery might take up to a year. On rare occasion, permanent damage is seen. Recurrence of the condition occurs in seven percent of patients. Cellular Level There are twelve cranial nerves in the head. These nerves receive impulses and direct reaction that controls most of our facial muscles. The face that we present while happy or sad is controlled by the cranial nerves.

While damage to any one of these nerves can result in Bell's Palsy, the implicated nerve is the seventh cranial nerve. This nerve is also called the facial nerve. It is a symmetrically paired nerve. It emerges from its nerve center in the brain and travels through the Fallopian canal that goes underneath the ear and enervates various muscles on either side of the face. (AAO-HNS, 2004) The Fallopian canal encloses the nerve for the most part. As most nerves are, a muscle sheath called the Myeline sheath also protects it.

Milder forms of Bell's palsy occur when damage occurs to this sheath. Specifically, facial expressions of sorrow, annoyance or happiness are controlled by the facial nerve. Also controlled is the blinking of the eyes (this is one of the symptoms that need treatment). The facial nerve controls the function of the stapes (the smallest bone in the body that is responsible for balance). It also controls the taste sensations in the tongue and the salivary glands. The latter explains the drooling.

Diagnoses Tingling in the eyelids or around the lips and sometimes a pain in the neck or ear region are first signs of the approaching condition. But these indicators are generally commonplace and may have other origins, so it is difficult to make really early diagnoses. Diagnosis is not difficult because the condition is evident. The facial paralysis is a direct indicator. Certain tests to check facial function are used by physicians. The damage to hearing and balance are tested. The amount of tears produced is also tested.

There is no specific test that can be conducted to identify the damage to the seventh cranial nerve. While making the diagnosis for Bell's Palsy, physicians are charged with ruling out other causes which might present symptoms similar to Bell's Palsy. Sometimes tumors or other non-related infections might also cause pressure on the facial nerves. X-rays of the skull, Magnetic Resonance Imaging and Computer Tomography (CT) tests will be conducted to rule out other causes. Symptoms The facial nerve controls many facial functions that we take for granted.

With the damage the symptoms therefore are myriad. Even the severity of the symptoms is varied. They range from mild to complete paralysis. The affected side is weak. The disrupted firing causes twitching. The affected side of the face has a characteristic droop to it. There is drooling because of the failure to control one side of the face and the excess salivary secretions. It also disrupts normal speech. Eventually the mouth appears dry. The ability to taste is affected. There is excessive tearing from the lachrymal glands.

These glands eventually also dry up. The inability of the eye to blink causes dryness.