Bell’s Palsy

The X-Factor winner Sam Bailey was recently diagnosed with Bell’s Palsy. It is a surprising and scary diagnosis for a celebrity. Let's look at what causes Bell’s palsy and how it can be managed.

Bell's palsy causes weakness or in extreme cases, paralysis of the muscles on one side of the face. The nerve that controls these muscles is quite aptly named as the “facial nerve”. Inflammation of this nerve causes the face to droop on that side. The inflammation may also affect one's sense of taste and the tear ducts.

One major factor that makes it such a scary disease is the speed of its onset. It develops in a day, sometimes even overnight. The good news is that the symptoms are self limiting most of the time and the problem clears up within a few weeks.

Bell’s palsy is not caused as a result of stroke or blood flow issues in the brain. Since, it is difficult to differentiate between the symptoms of stroke and Bell's palsy, any sudden onset of facial weakness should be evaluated on an emergency basis.

What causes Bell’s palsy? The herpes virus is thought to be the most common culprit. The virus attacks the nerve and causes inflammation. The nerve canal of the facial nerve is so narrow that even a slight amount of swelling can cause weakness of the muscles. Other viruses like the varicella virus which causes chicken pox have also been implicated. The key thing to remember is that Bell’s palsy is caused by viral infection rather than a circulation problem (like in the case of strokes).

The diagnosis and treatment of Bell’s palsy can be done with the help of patient’s brief history and physical examination. Sometimes there can be some confusing factors wherein the doctor faces difficulty in separating this problem from stroke symptoms or symptoms of a transient ischemic attack. In such cases, the doctor can order an MRI to make sure that there are no problems with the brain.

Treatment is all about accelerating the healing process. Doctors usually don’t prescribe anti-viral medicines unless absolutely necessary. Our immune system makes better and effective antivirals and they have no side effects as well. So, some doctors tend to take the hands off approach. The immune system kills the infection, gradually decreasing the nerve swelling and the face goes back to normal in about 8 weeks.

Some doctors also prescribe a short course of ‘steroid’ medicines to try and limit the nerve inflammation. It all depends on the doctor and the severity of the problem.

So the following symptoms needs be evaluated immediately:-

• Sudden weakness or paralysis on one side of the face. It can be hard to close the eye on that side of the face
• Drooling
• Watery eye or a dry eye
• Loss of ability to taste
• Pain in or behind the ear
• Numbness on the affected side of the face
• Increased sensitivity to sound