We’re walking down the street one day and suddenly we notice that we can’t close our eyes. We try to talk and realize that we can’t move half of our mouth or it feels extremely weak. We drool, or food or drink falls out of our mouths, as if we were coming out of the dentist under anesthesia. We run to the hospital and after several tests and urgent examinations we are told that we are not having a stroke but that we are **Bell’s palsy**.
What is this? What are we up to? In this article, we’re going to talk about that paralysis.
Bell’s palsy, also known simply as facial frigidity or cranial mononeuropathy VII is a neurological disorder in which part or all of the face suffers from paralysis or decreased muscle tone. This paralysis results from an injury or problem in the facial nerve or seventh cranial nerve, usually in the face of inflammation. This nerve allows the human being the mobility of the facial muscles, so that its alteration generates the difficulty or absence of voluntary movement.
This is a relatively common disorder . The most common symptoms are the above-mentioned paralysis (which usually occurs only in one half of the face), the inability to close one of the eyes, the deviation of the mouth towards the side that retains movement, drooling, and difficulties in speaking and eating. Tearing is also common.
Sometimes headaches, jaw pain or perceptual alterations, such as hyperacusis or inability to detect taste can appear in the affected hemicampus. These symptoms usually appear suddenly, although it may take two or three days for them to fully emerge and manifest themselves.
Although at first sight it may not seem excessively limiting, it should be borne in mind that it can be very damaging: difficulties in communication can greatly affect interpersonal relations or even at work. Likewise, these communication difficulties and others such as those related to drinking or eating can affect the patient’s self-esteem and can be a great source of frustration and stress.
Bell’s palsy is a disorder that can occur at any time in the life cycle, although it is more common in adulthood and middle age (it is rare before age sixteen). This type of paralysis is usually temporary (although it can last for months).
As we have said, this paralysis is caused by the swelling of the seventh cranial pair. However, the causes of this inflammation are unknown, being idiopathic (i.e. of unknown cause) in most cases. In fact, another name for this disorder is idiopathic facial paralysis .
In some cases there seems to be some link to infection with viruses such as herpes simplex, shingles, or HIV. Some cases have also emerged from influenza vaccination. It can also arise from having a head injury or trauma that can damage the nerve.
Another element that could cause it is the condition of some type of tumor that generates compression or directly affects the nerve , as well as a stroke. Finally, it should be mentioned that it has been found that being pregnant increases the risk of suffering this type of paralysis, as well as suffering from disorders such as diabetes or respiratory conditions.
Bell’s palsy is in the vast majority of cases temporary (about 80%), so requiring a specific treatment for this disorder is not common. In those cases where it is necessary because the paralysis persists, the possible reason for it must be explored , analyzing the reason for the malfunctioning of the seventh cranial nerve and applying a specific treatment for each case. For example, the use of antibiotics or antivirals in the case of bacterial or viral infection, or the treatment of a possible tumour.
It is common to apply steroids and anti-inflammatory drugs to reduce inflammation of the nerve and surrounding area. Bioelectrical muscle stimulation and physiotherapy can also facilitate nerve excitation and function.
In cases where it is difficult to close the eyes, artificial tears are also applied to keep them clean and moisturized. Finally there is the possibility of using decompression surgery , although it is not recommended and in many cases its real effectiveness is discussed.
The outlook in most cases is positive. Symptoms usually begin to gradually subside within the first few weeks in a process that can last several months. Recovery tends to be complete, although this will depend on the cause and type of condition. In other cases weakness or small spasms , or alterations such as taste, may appear.
In any case, it is essential to go to the doctor as soon as possible if our face or part of it is paralyzed: we must take into account that a sudden facial paralysis can also be the consequence of a stroke that could have severe consequences or even lead to death .
- National Institute of Neurological Disorders and Stroke (2016). Bell’s palsy. Published online. Available at: https://espanol.ninds.nih.gov/trastornos/paralisis_de_bell.htm
- León-Arcila, M.E.; Benzur-Alalus, D. and Álvarez-Jaramillo, J. (2013). Bell’s palsy, case report. Spanish Journal of Oral and Maxillofacial Surgery, 35 (4). Barcelona.