Bell’s Palsy is a sudden weakness or loss of function of certain facial muscles, usually on one side of the face, caused by swelling of a facial nerve.
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Fifteen-year-old Shelly woke up one morning feeling like she had just received a shot of Novocain from the dentist. When she looked in the mirror, she saw that her face seemed limp on one side. She could not smile, and only one side of her face seemed to work. Shelly screamed for her parents and they came running. When they saw her face, they became worried that she had had a stroke* or had developed a brain tumor. They rushed her to the hospital emergency room.
- * stroke
- may occur when a blood vessel bringing oxygen and nutrients to the brain bursts or becomes clogged by a blood clot or other particle. As a result, nerve cells in the affected area and the specific body parts they control cannot function.
At the hospital, the doctor examined Shelly and asked her and her parents about Shelly’s medical history. Then the doctor performed several diagnostic tests to find out whether she had high blood pressure or Lyme Disease. At that point, the doctor was able to explain that the symptoms indicated Bell’s Palsy, a fairly common and harmless condition.
It took three weeks for Shelly’s condition to go away, and those three weeks felt more like three years to Shelly, but she was grateful that it was not something more serious.
Bell’s Palsy is a condition that occurs when the facial nerve becomes irritated. The facial nerve runs from the brain through a small hole in the skull. Sometimes the facial nerve becomes irritated or swollen. The irritated nerve does not send normal signals to the muscles on one side of the face. The result is partial or complete loss of muscle function (called “palsy”).
The symptoms of Bell’s Palsy begin suddenly and usually worsen over two to five days. The sudden numbness or weakness characteristic of Bell’s Palsy gets worse during the day, and the face feels stiff and pulls to one side. People with Bell’s Palsy typically have problems closing one eye and cannot wrinkle their forehead. They may feel pain behind the ear, they may experience involuntary facial movements called “tics,” and hearing in the ear on the affected side may be very sensitive. They also may drool and have trouble eating and talking.
People with a stroke can look like they have Bell’s Palsy, so it is important to visit a doctor to find out what is causing facial paralysis. People with Bell’s Palsy often fear a brain tumor, but the symptoms of a brain tumor usually occur more gradually than the sudden start of Bell’s Palsy.
Bell’s Palsy is an idiopathic (id-e-o-PATH-ik) disease, which means that its cause is unknown or uncertain. One possible cause of Bell’s Palsy is irritation of the facial nerve after a viral infection, such as herpes zoster (which causes shingles) or herpes simplex (the cold sore virus). It also may be related to a blow to the face that damages the nerve or to conditions such as Lyme disease, diabetes, and high blood pressure.
Bell’s Palsy may happen to men and women of all ages but is most common between the ages of 30 and 60. Pregnant women and people with diabetes, a cold, or the flu are more susceptible than the average person. One person in 60 to 70 develops Bell’s Palsy during his or her lifetime, which translates to about 40,000 people per year in the United States.
Eighty percent of people with Bell’s Palsy begin to recover several weeks after their symptoms begin, and they recover completely within several months without treatment. A few people never recover completely and some of their symptoms continue permanently.
During recovery, the biggest concern is protecting the exposed eye from dryness and injury. Doctors will sometimes prescribe antiviral medications during the first 5 to 6 days of the onset of Bell’s Palsy, and anti-inflammatory drugs sometimes help reduce swelling of the nerve.
Bell and the Brain
Sir Charles Bell (1774-1842) was a Scottish scientist who studied anatomy (the structure of organisms). His investigations of the brain have been called the “Magna Carta of Neurology.” The Magna Carta or “great charter,” was a famous document in English history, so this is quite a compliment to Sir Charles Bell. He received the first medal awarded by the Royal Society of Great Britain for his book, New Idea of Anatomy of the Brain. Bell was the first to describe how sensory neurons (nerve cells) carry messages to the brain and how motor neurons carry messages to muscles and glands. Because of his work with nerve anatomy, Bell’s Palsy was named after him.
Dambach, J.P. Surviving Bell’s Palsy: A Patient’s Guide to Facial Paralysis Management. Homosassa, FL: J.P. Dambach, 1997. This book describes the emotional effects of Bell’s Palsy. It is not a medical guide but a tool for discussion by patients and doctors.
The U.S. National Institute of Neurological Disorders and Stroke posts a fact sheet about Bells Palsy at its website. http://www.ninds.nih.gov/patients/Disorder/bells/bells.htm
National Centers for Facial Paralysis, Inc. This organization has offices in eight cities. Telephone 888-30BELLS http://www.bellspalsy.com
Bell’s Palsy Research Foundation, 9121 East Tanque Verde, Suite 105-286, Tucson, AZ 85749. Telephone 520-749-4614
American Academy of Otolaryngology, Head and Neck Surgery, Inc., 1 Prince Street, Alexandria, VA 22314. Telephone 703-836-4444