Bell’s palsy is a common condition that results from the paralysis
of the facial nerve. This condition is quite common. It usually
affects one side of the face in the forehead and lower facial areas.
Several physical manifestations of Bell’s palsy include difficulty
closing one eye, slurred speech, drooping of one corner of the
mouth, inability to whistle, drooling when drinking, or a wrinkle-
free forehead on one side.
Bell’s palsy can occur very rapidly. Men and women are affected
equally. Most cases occur between the ages of twenty and forty. It
usually takes close to three weeks for it to reach its maximum
effect. From the maximum effect, most cases recover within three
weeks. Severe cases can take up to six months to resolve
completely. Typically, recovery results in very few if any
permanent manifestations. Patients over the age of sixty are at a
greater risk of being left with long term effects of Bell’s palsy.
Incomplete recovery is more likely with repeated attacks.
What causes Bell’s palsy? That is difficult to answer. It is thought
to be caused by inflammation of the facial nerve. The facial nerve
is the cranial number seven. It is responsible for the controlling the
muscles of the forehead, eyebrows cheeks, eyelids, lips and the
lacrimal gland (which secretes the water for your tears). Several
conditions can be linked to Bell’s palsy such as herpes simplex
infections, bacterial infections, shingles, Lyme disease, upper
respiratory tract infections, diabetes, fever, dental surgery,
exposure to extreme cold, or menstruation. A stroke can also cause
the same type of facial paralysis however there is also weakness in
other parts of the body.
Blinking is required to spread fresh tears across the eye and to
reduce the evaporation of tears into the atmosphere. Since patients
affected by Bell’s palsy cannot blink one eye, the cornea (clear
cover of the eye) becomes dry resulting in ocular discomfort. The
lack of tears covering the cornea can lead to corneal scarring and
eventually severe vision loss in the worst cases.
Treating the ocular effects of Bell’s palsy requires frequent use of
artificial tears drops during the day and artificial tear ointments at
bedtime to keep the cornea moist. Some patients need to wear an
eye patch or tape their lids shut while sleeping for added relief. In
more severe cases of dry eye due to Bell’s palsy, there are a couple
of surgical options available. The first one involves implanting a
tiny gold weight into the upper lid to pull the lid down. The second
option is called a partial tarsorrhaphy. This involves the upper and
lower lids to become partially sutured together to reduce corneal
exposure. There is some debate in the medical community
regarding the role of oral antiviral and corticosteroid medications
in treating Bell’s palsy.
Bell’s palsy can be a very frustrating and painful condition to
endure. For those where recovery is not complete the change in
the appearance of one’s facial features can be a dramatic change.
Fortunately, most recover completely with no increased chance of