April 16, 2024

Bell’s palsy is a temporary condition where facial muscles go through a short period of paralysis, causing weakness and drooping on one side of the face. It may occur due to a viral or bacterial infection.

It’s often mistaken for a stroke because it affects the facial nerve. Unlike a stroke, Bell’s palsy is linked to damage in the facial nerve.

You may have difficulty smiling or closing your eye on the affected side. In most cases, it  usually gets better on its own, taking anywhere from two weeks to six months to resolve, depending on how severe it is. 

Notably, it’s more common in people dealing with upper respiratory infections like colds or the flu and those managing diabetes.

Around 40,000 individuals in the United States experience Bell’s palsy annually. Both men and women of different ages are susceptible, but it’s less common in those under 15 or over 60.

The condition is named after Sir Charles Bell, a respected 19th-century Scottish surgeon who studied it extensively. His work has played a crucial role in helping us understand Bell’s palsy and its unique characteristics.


What Causes Bell’s palsy?

Bell’s palsy happens when the seventh cranial nerve swells or gets compressed, leading to weakness or paralysis in the face.

The exact cause of this nerve damage is unclear, but many researchers think it’s likely due to a viral infection.

Several viruses and bacteria have been linked to the development of Bell’s palsy. These include 

  • herpes simplex (causing cold sores and genital herpes)
  • HIV, sarcoidosis (causing organ inflammation)
  • herpes zoster virus (causing chickenpox and shingles)
  • Epstein-Barr virus (causing mononucleosis), and Lyme disease (a bacterial infection from infected ticks)

The National Institute of Neurological Disorders and Stroke explains that when the facial nerve is inflamed, it decreases blood flow and oxygen to the nerve cells. This can lead to paralysis of the facial muscles. 

Additionally, the National Organization for Rare Disorders mentions that certain individuals may have a genetic tendency to develop Bell’s palsy.


What are the symptoms of Bell’s palsy?

Sudden signs of Bell’s palsy can include:

  • Quick onset of mild to complete paralysis on one side of your face within hours to days
  • Facial drooping and difficulty in making expressions like closing your eye or smiling
  • Drooling
  • Jaw or ear pain on the affected side
  • Increased sensitivity to sound on the affected side
  • Headache
  • Loss of taste
  • Changes in tear and saliva production
  • In rare instances, Bell’s palsy may affect nerves on both sides of your face.

When to seek medical attention:

If you experience any form of paralysis, it’s crucial to seek immediate medical help as it may indicate a stroke. While Bell’s palsy isn’t caused by a stroke, it can produce similar symptoms.

If you have facial weakness or drooping, consult your healthcare provider to determine the underlying cause and severity of the issue.

What are the risk factors for Bell’s palsy?

1. Pregnancy-related Risk:

  • Bell’s palsy is more common in individuals who are pregnant, particularly during the third trimester and within the first week after giving birth.
  • The exact reasons for this association are not entirely clear, but hormonal changes during pregnancy could play a role.

2. Upper Respiratory Infections:

  • People with Bell’s palsy often have a history of upper respiratory infections, such as the flu or a cold.
  • The link might be related to viral infections, with some viruses potentially triggering the onset of Bell’s palsy.

3. Diabetes Connection:

  • Individuals with diabetes face a higher risk of developing Bell’s palsy.
  • The mechanism behind this connection is not fully understood, but it could be related to the impact of diabetes on the nervous system.

4. High Blood Pressure:

  • High blood pressure has been identified as a factor associated with Bell’s palsy.
  • The exact relationship between hypertension and the development of Bell’s palsy is an area of ongoing research.

5. Obesity as a Factor:

  • Obesity is another condition linked to an increased risk of Bell’s palsy.
  • The reasons for this association may involve both physiological and lifestyle factors that contribute to the susceptibility of developing the condition.

How is Bell’s palsy diagnosed?

1. Physical Examination:

  • A doctor examines upper and lower facial muscles for weakness on one side (forehead, eyelid, mouth).
  • Focus on symptoms that began within the past 72 hours.
  • Excludes other causes of facial paralysis during the exam.

2. Exclusion of Other Causes:

  • No specific laboratory test exists for confirming Bell’s palsy.
  • Routine lab or imaging studies are usually unnecessary but can help rule out alternative conditions.

3. Imaging Studies (if needed):

  • Considered if there’s gradual progression of face weakness or involvement beyond facial expression.
  • May be useful if taste and hearing sensitivity are affected.

4. Electromyography and Nerve Conduction Studies:

  • Aid in determining disorder severity.
  • Provide insight into the likelihood of recovery.

How can Bell’s palsy be treated?

Usually, Bell’s palsy gets better on its own, but it might take weeks or months for your face muscles to fully recover.

Treatments that may help include medication such as:

  • Corticosteroid drugs to reduce inflammation.
  • Antiviral or antibacterial meds if a virus or bacteria causes Bell’s palsy.
  • Over-the-counter pain meds like ibuprofen or acetaminophen for mild pain.
  • Eye drops to keep the affected eye moist.

Home treatment:

  • Use an eye patch for a dry eye.
  • Apply a warm, moist towel on your face to ease pain.
  • Try facial massage.
  • Do physical therapy exercises to activate your facial muscles.

Foods to be Consumed

It is important to maintain a healthy and nutritious diet to prevent and treat this problem.

A soft blend and full liquid diet is necessary in this condition. Here is a list that you should embrace;

Fruits

Apple, Papaya, Peach, Pear, Grapes, Melon, Watermelon, Banana, Blueberries, Kiwi, Strawberries.

Vegetables

Bottle gourd, Ridge gourd, Bitter gourd, Boiled potato, Pumpkin, Spinach, Fenugreek, Beetroot, Carrot, Turnip, Peas, Beans, Broccoli, Cabbage, Cauliflower, Onion, Ginger, Garlic.

Grains

Wheat, Millet, Brown rice, Whole grain, Oatmeal.

Dairy Product

Cow’s milk, Cow’s ghee, Buttermilk, Curd, Yogurt. High-fat milk, Butter, Cheese, Mayonnaise.

Legumes

Yellow lentil, Pink lentil, Green gram, Chick peas, Soya bean. 

Nuts

Almonds, Figs, Raisins, Walnuts.

Oils

Olive oil, Coconut oil, Mustard oil, Sesame oil, Sunflower oil.

Spices

Cumin, Coriander, Fenugreek, Turmeric, Carom seeds, Mint, Green cardamom, Black pepper.

Beverage

Green tea, Fresh juices, Herbal tea, Coconut water.

Foods to be avoided

During Bell’s palsy, it’s advisable to avoid foods that are excessively spicy or extremely hot, as they may exacerbate symptoms due to potential irritation. These include;

Oranges, Frozen or canned fruits, Eggplant, Ladyfinger, Taro root, Chili pepper, Yam, White bread, Maize, Refined grains, White rice, High-fat milk, Butter, Cheese, Mayonnaise, Black gram, Kidney beans, White split gram, Peanuts, Cashew nuts, Pistachios, Refined oil, Excessive salt, Red chili, Tea, Coffee, Alcohol, Carbonated drinks.


How to manage Bell’s palsy

  • Artificial Tears or Eye Drops: Use these throughout the day to prevent dry eyes, especially if your eyelid doesn’t close completely. Consult your eye doctor for specific usage guidelines.
  • Heavy Lubricating Ointment at Night: Apply a thicker ointment before sleeping to retain moisture, although it may cause temporary blurry vision.
  • Taping the Affected Eye at Night: Use surgical tape to gently close your eyelid during sleep to prevent dryness, being careful when removing it in the morning.
  • Eye Patch or Moisture Chamber: Consider using these to minimize moisture loss and prevent dry eyes.
  • Drinking Through a Straw: Ease challenges in drinking caused by a droopy mouth by using a straw to minimize spills.
  • Emotional Support: Share your feelings about appearance changes with trusted friends, counselors, or therapists.
  • Alternative Therapies: While not a cure, practices like relaxation techniques can contribute to improved well-being.
  • Rest and Health Focus: Prioritize rest, adequate sleep, and a balanced diet to manage stress associated with facial paralysis.

Complications

Mild Bell’s palsy usually resolves within a month, but severe cases with complete facial paralysis have varying recovery times.

  • Complications may involve irreversible damage to the facial nerve.
  • Irregular regrowth of nerve fibers can lead to synkinesis, causing involuntary muscle contractions during certain movements, such as smiling.
  • Excessive dryness and scratching may result in partial or complete blindness in the eye that doesn’t close properly.

What does the future look like for individuals diagnosed with Bell’s palsy?

People with Bell’s palsy usually have a positive long-term outlook. How quickly you recover depends on how much the nerves are affected.

For those with mild nerve damage, improvements may become noticeable within 2 to 3 weeks from the onset of initial symptoms.

However, if the nerve damage is more severe, the recovery process may extend to 3 to 6 months before significant improvement is observed. In rare instances, there’s a possibility of symptoms persisting or becoming permanent.

It is crucial to promptly contact your doctor if you experience any symptoms associated with Bell’s palsy.

Seeking immediate medical attention can contribute to expediting the recovery period and reducing the likelihood of complications.

Early intervention and appropriate treatment play a vital role in managing Bell’s palsy effectively.

What’s the latest information on Bell’s palsy?

The National Institutes of Health, specifically NINDS, is deeply involved in researching neurological disorders.

They’re looking into how the nervous system operates and what goes wrong in cases like facial paralysis. 

Researchers are exploring topics like nerve mechanisms in facial movement, the causes of nerve damage leading to facial paralysis, and potential treatments.

Some studies focus on the effects of facial paralysis surgery, therapies for eye issues associated with facial nerve problems, and the use of electrical stimulation for treating facial paralysis and nerve weakness.

This comprehensive research aims to pinpoint the cause of Bell’s palsy and discover effective treatments.


Conclusion 

Bell’s palsy is characterized by the weakening or paralysis of facial muscles, typically affecting only one side of the face.

This condition arises when the cranial nerve responsible for controlling facial muscles becomes inflamed, swollen, or compressed.

The process of diagnosing Bell’s palsy can be frustrating due to the uncertainty surrounding its exact cause.

Moreover, there is no specific medication or swift treatment available for its resolution, and what proves effective for one individual may not work for another.

Although Bell’s palsy is usually a temporary condition, it demands patience while awaiting the restoration of nerve and muscle function in the affected facial area.

While seeking guidance and support from your doctor is advisable, it’s important to acknowledge that various strategies may be attempted to minimize the impact on your face and overall life as you navigate the path to recovery.


References 

Paralysis: What is it, diagnosis, management and prevention.https://my.clevelandclinic.org/health/diseases/15345-paralysis

Bell’s palsy | The National Institute of Neurological Disorders and Strokehttps://www.ninds.nih.gov/health-information/disorders/bells-palsy

Bell’s palsyhttps://www.mayoclinic.org/diseases-conditions/bells-palsy/symptoms-causes/syc-20370028

What Is Bell’s Palsy?https://www.healthline.com/health/bells-palsy

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