Facial Paralysis (Bell's Palsy) : Sign, Symptom, Cause, Risk Factor, Diagnosis, Treatment And Drug

Bell's Palsy is a form of facial paralysis resulting from a dysfunction of the seventh cranial nerve (the facial nerve) causing an inability to control facial muscles on the affected side.It causes one side of face to droop or become stiff.It often happens overnight. Bell's palsy is temporary.The time of Bell's Palsy recovery may vary depending on the severity of nerve damage. Symptoms usually begin to improve after about two until three weeks.They have gone within two months.Its symptoms improve without treatment in most cases. The facial muscles regain their normal strength for several weeks or months.  It most commonly occurs between the ages of 15 and 60.Bell's Palsy does not affect the brain or other parts of the body.It is a local problem confined to the facial nerve and facial muscles.In most cases, a Bell's Palsy is a one-off.It is an inflammatory condition that leads to swelling of the facial nerve.The exact cause of Bell's palsy is unknown.Studies suggest that this new activation could be preceeded by trauma, environmental factors, metabolic and emotional disorders.


Signs and Symptoms of Bell's Palsy

• An inability to make facial expressions, such as smiling, frowning, closing the eye
• Weakness of the face which  is usually one side
• Drooling
• Pain around the jaw or in/behind ear on the affected side
• Difficulty eating and drinking
• Dry or watery eye 
• Dry mouth
• Muscle twitches in the face
• Headache
• Increased sensitivity to sound on the affected side
• Loss of taste sensation

Causes of Bell's Palsy

Bell's Palsy is often linked to exposure to a viral infection.Viruses that have been linked to Bell's Palsy include :

• Herpes Simplex, which causes cold sores and genital herpes
• Herpes Zoster Virus which causes chickenpox and shingles
• Epstein-Barr Virus which causes mononucleosis
• HIV which damages the immune system
• Sarcoidosis which causes organ inflammation
• Adenovirus which causes respiratory illnesses
• Mumps Virus which causes mumps
• Cytomegalovirus infection
• Rubella which causes German measles
• Influenza B which causes flu
• Coxsackievirus which causes hand-foot-and-mouth disease

Risk Factors of Bell's Palsy

• Pregnancy, especially during the third semester or the first week after giving birth
• Diabetes
• An Upper Respiratory Infection, such as flu or cold
• Family history of Bell's Palsy

Diagnosis

A doctor will ask questions about symptoms and do many tests.

• Physical Examination is to determine the extent of the weakness in the facial muscles.
• Blood Test is to check for the presence of a bacterial or viral infection.
• Electromyography (EMG) is a test that confirms the presence of nerve damage and determines its severity.
• Magnetic Resonance Imaging (MRI) or Computerized Tomography (CT) is to rule out other possible sources of pressure on the facial nerve, such as tumor, skull fracture.

Treatment of Bell's Palsy

I. Home Remedy

1. Facial pain treatment by putting a washcloth soaked in warm water on the face several times a day to relieve pain.
2. Massaging and Exercising the face to relax facial muscles.
3. Eye will not close completely treatment by doing many ways :

• Using the finger to close the eye repeatedly throughout the day.
• Tapping the upper and lower lid together when sleeping.
• Using eye drops to lubricate the eye during the day.
• Using eye ointment to lubricate the eye overnight.
• Wearing eye glasses during the day to protect the eye.
• Wearing an eye patch at night.

II. Alternative Medicine

• Acupuncture can stimulate nerves and muscles by placing thin needles into a specific point in the skin.
• Meditation and Yoga may relieve muscle tension and chronic pain.
• Vitamin Therapy uses vitamin B6 and vitamin B12 and zinc to help the growth of nerve.
• Biofeedback Training uses thoughts to control the body.

III. Physical Therapy

A physical Therapist will teach how to massage and exercise the facial muscles to prevent this from occuring.

IV. Physiotherapy

Physiotherapy helps to maintain muscle tone of the affected facial muscles and stimulate the facial nerve.

V. Surgery

Surgery is rarely done for Bell's Palsy.It is done if Bell's Palsy does not recover fully.

• Plastic Surgery may be needed to correct lasting facial nerve problems but it is rare.
• Decompression Surgery is not recommended because it causes facial nerve injury and permanent hearing loss.
• Smile Surgery or Smile Reconstruction is a surgical procedure that may restore the smile for people with facial nerve paralysis.This surgery is unknown to be beneficial or harmful.

Drug for Bell's Palsy

• Corticosteroid drugs reduce inflammation.
• Antiviral medication may be prescribed if Bell's Palsy is caused by a virus
• Over-the-counter-pain medications, such as ibuproven (Advil, , Motrin IB) or acetaminophen (Tylenol), which help in relieving pain.
• Valacyclovir (Valtrex) is sometimes given in combination with prednisone in people with severe facial palsy.

Complication

Complication may happen in more severe cases of Bell's Palsy as the following :

• The damage of the seventh cranial nerve.
• The excessive dryness in the eye leads to eye infection, ulcers and even blindness.
• Synkinesis is a condition in which moving one body part causes another to move involuntarily.For instance, the eye may close when smiling.