Bell's Palsy

Information on Bell's Palsy and facial nerve damage.

Select a Topic

  1. What are the Symptoms of Bell's Palsy?
  2. What Causes Bell's Palsy?
  3. Bell's Palsy in Children
  4. Bell's Palsy During Pregnancy
  5. Treatments for Bell's Palsy
  6. Tips for How to Deal with Bell's Palsy
  7. Massage Therapy for Bell's Palsy

What is Bell's Palsy?

Bell's Palsy is a neurological disorder that causes the facial muscles on one side of the face to suddenly weaken or become paralyzed. The muscles that close the eye control the tear glands, as well as control one of the salivary glands and the taste buds in front of the tongue are all controlled by the facial nerve. When damage or trauma is caused to the facial nerve, it usually only affects one side of the face.

The electrochemical signals sent from the brain to these muscles travel along the facial nerve. If the facial nerve is disrupted, no signals can get through to these muscles and, depending on how many of the nerve fibers within the facial nerve are involved, the affected half of the face experiences muscle weakness or paralysis and this is what is known as Bell's Palsy.

People with Bell's Palsy experience an interference with normal facial actions and functions such as closing the eye, eating, smiling and their speech may also be slurred. Other symptoms which are present include tearing of the eye, loss of taste, slurred speech, sensitivity to sound, facial paralysis and drooling. This condition occurs suddenly, and usually peaks within 48 hours.

People often think that they are experiencing a stroke, and are not familiar with the milder symptoms of Bell's Palsy that often precede the involvement of the facial muscles.

Bell's Palsy affects about 40,000 people in the United States every year. Bell's Palsy is more common in young adults, the elderly, diabetics and pregnant women. Children are not immune to it but they do tend to recover extremely well. Generally there are no other medical risks associated with this condition but developing Bell's Palsy during pregnancy may be associated with the development of pre-eclampsia.

What are the Symptoms of Bell's Palsy?

The symptoms of Bell's Palsy tend to progress very quickly. The symptoms are often not recognizable at first but will develop over a period of a few days. The warning signs are usually neck pain, pain behind the ear or pain in the back of the head.

Common Symptoms of Bell's Palsy
  • Anxiety
  • Sore Throat
  • Muscle Spasms
  • Facial pain or cramping and twitching or tingling on face
  • Vertigo or Dizziness
  • Slurred speech
  • Excessive Eye Tearing
  • Eye Strain
  • Facial Sagging such as a Drooping mouth or an overall droopy appearance
  • Jaw Tension and Pain
  • Facial muscle weakness or paralysis of the muscles
  • Drooling
  • Nose is constantly stuffed or nose runs
  • Changes in the amount of tears and saliva your body produces
  • Impossible or difficult to blink
  • Dry mouth, loss of taste, and diminished or distorted taste
  • Headache
  • Hypersensitivity to sound (hyperacusis)
  • Hearing loss
  • Pain in or near the ear
  • Difficulty eating and drinking
  • Excess or reduced salivation
  • Sudden onset of paralysis or weakness on one side of your face, making it difficult to smile or close your eye on the affected side
  • The affected half of the face is usually flat and expressionless but it is not uncommon for patients to complain about the unaffected side of the face, saying that it feels twisted or uncomfortable.
  • Facial swelling, e.g., forehead wrinkles disappear

What Causes Bell's Palsy?

Though the exact causes of Bell's Palsy are not known, the condition is thought to be brought upon due to inflammation and swelling of the facial nerve. This in turn could be due to:

  • Facial Nerve Damage
  • Flying
  • Lyme Disease caused by Insect Bites
  • Chemotherapy
  • Traumatic injury to the face or head (such as a skull fracture)
  • Myasthenia gravis or tuberculosis
  • Viral infections such as herpes, mumps, influenza, a cold, infectious mononucleosis or HIV
  • Bacterial infections such as Tuberculosis
  • Multiple sclerosis
  • Guillain-Barre Syndrome
  • Chronic disease such as diabetes
  • Tumor causing nerve compression
  • Stress
  • Pregnancy

Bell's Palsy in Children

Bell's Palsy occurring in older children is more common and usually occurs within one to two weeks of a viral infection. Viral infections such as Herpes Simplex 1, Epstein- Barr and Lyme disease are known as the two major culprits for Bell's Palsy. The occurrence of Bell's Palsy is said to be the result of an allergic reaction to one of these viruses.

Bell's Palsy During Pregnancy

Bell's Palsy is more common in women who are pregnant than not pregnant. Bell's palsy is associated with preeclampsia, a form of toxemia which causes high blood pressure and swollen ankles in the advanced stages of pregnancy. While Bell's Palsy causes no immediate risk for mother or child, preeclampsia is a serious condition and must be watched carefully by a physician.

Alternatively, some women suffer from Bell's Palsy right after childbirth, this is due to the extreme physical and emotional stress of labor and the condition usually remedies itself within a couple weeks. New mothers should feel no other side effects other than facial pain and paralysis, and will be able to perform motherly duties including breastfeeding. If medication is the treatment option for Bell's Palsy, it is important to make sure the medication isn't passed through breast milk.

Diagnosing Bell's Palsy

The diagnosis of Bell's Palsy is determined by the patient's medical history, a thorough physical examination and laboratory tests. Tests for diabetes, Lyme disease, myasthenia gravis, sarcoidosis, cancer, facial tumors, AIDS and Guillain Barre might also be performed to rule out other conditions that may cause facial paralysis.

Common Tests Used in Diagnosis
  • MRI Scan (magnetic resonance imaging) and CT Scan (computerized tomography)
    These imaging tests are used to determine tumors, bone fractures, infections or abnormalities around the facial nerve.
  • Hearing and Balance Tests
    The tests are able to assess if there is any injury to the inner ear and if the nerve responsible for hearing is damaged. It is also able to determine the eye's ability to produce tears and whether the sense of taste functions.
  • EMG (Electromyography)
    The injury is assessed by stimulating the facial nerve electrically, and can also determine the progression and extent of the injury.

Treatments for Bell's Palsy

In mild cases of Bell's Palsy, treatment is not actually required, and the nerve will heal by itself in due course. However, more severe cases of this condition require treatment. Various types of treatments such as conventional medicine and complementary may be effective if integrated into a broader treatment plan.

Using Conventional Medicines for Treatment
  • Anti-viral drugs (such as acyclovir) may treat the herpes viruses if this is one of the suspected causes of Bell's Palsy and facial nerve damage or inflammation.
  • Corticosteroids, such as prednisone, are used to reduce swelling and inflammation of the facial nerve and prevent any possible ot further facial nerve damage.
  • A Vitamin B12 injection can protect the nerves and reduce nerve inflammation
  • Botulinum toxin (Botox) can be injected into the upper eyelid to protect the eye and also to reduce facial spasm.
  • If facial nerve damage occurs, surgical treatments such as facial nerve repair, nerve substitution and muscle transposition may be needed if the condition does not improve or remit, in order to reduce distortion of the facial features and restore function.
  • A surgical procedure called tarsorrhaphy may improve eyelid closure.
  • Plastic surgery may be performed to improve permanent facial drooping.
Other Therapies for Bell's Palsy
  • Physiotherapy
  • Acupuncture
  • Massage
  • Facial exercises

Massage Therapy for Bell's Palsy

A twenty minute face massage should be a daily routine for those suffering with Bell's Palsy. A face massage can help to keep the paralyzed area of the face stimulated plus soothe any pain associated with the condition.

Using a circular motion, work down from just above the eyebrows the chin, paying special attention to the area right below the cheekbone. Preferably massaging exercises should be done at least twice a day, once in the morning and once at night.

Diet for Relief of Bell's Palsy

Vitamin A that is found in foods like liver, eggs, whole milk and other protein rich foods helps to combat viruses thus relieving symptoms of Bell's Palsy. Copper which is essential for nerve health can also help ease symptoms of Bell's Palsy. Copper can be found in beans, nuts, potatoes, dark leafy greens, dried fruits such as prunes, cocoa and black pepper.

Some people suffering from numbness around the mouth find it hard to eat solid foods; in this case, it is important to still get the nutrients needed to combat Bell's Palsy. Smoothies consisting of fruits and veggies, with a small addition of protein powder can help energize the body and mind while dealing with Bell's Palsy.


Tips for How to Deal with Bell's Palsy

  • Bell's Palsy recovery often includes special care for the eye on the affected side of the face. Bell's Palsy makes it hard to close or blink the eye, and without these actions it is difficult to maintain moisture in the eye.
  • If the eye becomes dry, and is exposed to foreign bodies because it cannot close, it will become damaged. Consultation with an ophthalmologist is recommended. Use the following safety measures to keep the eye moist:
  • Administer artificial tears every 2 hours
  • Wear sunglasses or an eye patch to protect the eye and reduce dryness
  • Apply a lubricant and tape the eye shut before you sleep to keep the cornea from drying
  • A weight may also be placed in the eyelid to keep it shut
  • About 50% of Bell's Palsy patients will experience a complete recovery in two to three weeks.
  • Bell's Palsy recovery depends on the severity of the nerve damage. If nerve damage is mild, recovery can be expected to be quick – and the patient should be healed within weeks. However, if the damage is more severe, recovery can take longer. Approximately 7% of patients experience a recurrence of Bell's palsy, with an average time span of ten years. Bell's Palsy has an increased tendency to recur in diabetics.
  • It is not uncommon for people suffering from Bell's Palsy to become self-conscious because of their facial disfigurement, and they tend to shy away from others and isolate themselves. There are various treatment options and coping mechanisms to manage this condition and to ensure a good quality of life.
Tips for Managing Bell's Palsy

There are basic wellness methods and lifestyle considerations that can aid in Bell's Palsy recovery patients to deal with their condition more effectively. These helpful tips include:

  • Eating a healthy and balanced diet rich in leafy, green vegetables
  • Exercising regularly
  • Practice facial massage and facial exercises several times a day
  • Increase intake of Vitamin B12, B6 and zinc supplements to promote nerve growth
  • Manage stress levels by practicing relaxation exercises
  • Investigate acupuncture, electrical stimulation and biofeedback training
  • Apply moist heat to the paralyzed areas to help reduce pain
  • Massage affected area
  • Keep the face warm – wear a scarf or a jacket with a hood, because exposure to cold brings on paralysis
  • Try drinking juice, water or cold drinks with a straw
  • Cut food into small pieces and eat on the side of your mouth that feels most comfortable
  • Wear a piece of cotton wool under your eye patch as it prevents dust from settling in
  • Wear a pair of goggles when you shower to prevent soap and shampoo from affecting your weak eye
  • Be positive and patient
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