Bell’s Palsy: Causes and Cure(s)

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Majid Kirmani

Bell’s palsy is a medical condition that causes a temporary weakness or paralysis of the muscles of the face. It is named Bell’s palsy after Charles Bell (a famous anatomist) who first discovered it. It can occur when the nerve (seventh cranial nerve) that controls the muscles of the face is injured, infected, inflamed or compressed. Mostly it is idiopathic (due to unknown cause).
In Bell’s Palsy, one side of the face becomes weak or loses control. A patient can have difficulty in smiling, chewing or closing an eye on the affected side. The mouth deviates to the unaffected side. The affected side is pulled towards the opposite side as the opposite side muscles are stronger than the affected side. In most cases, Bell’s palsy is temporary and symptoms usually go away after a few weeks.
Although Bell’s palsy can occur at any age, the condition is more common among people between ages 14 to 60 years. Even children under the age of 3 years are also affected. Bell’s palsy is completely curable. But the recovery varies from patient to patient depending on cause and so on.
Symptoms:
The symptoms of Bell’s palsy can develop one to two weeks after a person has the flu, ear or eye infection. Symptoms usually appear abruptly and the patient may notice sudden difficulty in eating, drinking and so on.In rare cases, Bell’s palsy may affect both sides of the face.

Common signs and symptoms are:
1.Drooling.
2.Difficulty in eating and drinking.
3.Inability to make facial expressions, such as smiling or frowning etc.
4.Facial muscle weakness.
5.Inability to close the affected eye.
6.Food gets accumulated in the mouth on the affected side.

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Diagnosis:-
There is no specific test for Bell’s palsy as such. Your doctor or physiotherapist will ask you to perform some activities like closing your eyes, smiling wide, raising your eyebrows and so on. After a physical examination, your doctor may advise some tests like CT Brain or MRI Brain to rule out any kind of stroke/tumour etc. Electromyography (EMG) test can confirm the presence of nerve damage and determine its severity.
Treatment:
In most cases, Bell’s palsy symptoms improve without treatment. However, it can take several weeks or months for the muscles of your face to regain their normal strength.
The following treatments help in the recovery of Bell’s Palsy:

Medication:
1.Corticosteroid drugs, which reduce inflammation are prescribed in a tapering dosage(decreasing dosage).
2.Antiviral or antibacterial medication may be prescribed if a virus or bacteria caused your Bell’s palsy.
3.Over-the-counter pain medications, such as ibuprofen or acetaminophen, which can help relieve mild pain.
4.Eye drops to prevent dry eye or eye infection.
Surgery:-In very rare cases surgery is advised to relieve the pressure on the facial nerve but there is a risk of facial nerve injury.

Physiotherapy Treatment:
Physiotherapy plays a good role in speedy recovery of Bell’s palsy. A physiotherapist can teach you good facial muscle strengthening exercises and can also use some Electrotherapy to assist the recovery.
1.Electric Muscle stimulation is given to stimulate the facial nerve and facial muscles.
2.Facial muscle strengthening exercises are taught to the patient.
3.Facial muscle Effleurage is given which helps in lymphatic drainage.
4.Taping or eye patch can be used for eye closure.
5.Taping of affected muscles can be done to hold the muscles in the proper position.
6.Moist Heat helps to relieve pain if any and also increases blood circulation.
Apart from all this, a Bell’s Palsy patient should avoid exposure to cold climate, take proper eye care (use sunglasses), take few chewing gums in a day, blow air in balloons, recite vowels (AEIOU), try to whistle and practice all advised exercises preferably in front of a mirror.

—The author, a Physiotherapist at District Hospital, Baramulla, can be reached at:
majidkirmani@gmail.com