Bells palsy, also called facial palsy, is a disorder caused by damage to the facial nerve, the nerve that supplies the muscles of the face. It occurs when the nerve that controls movement on one side of the face becomes inflamed. The cause of the nerve irritation is unknown but some experts think it may be from a virus. Bells palsy is a type of facial paralysis that results in an inability to control the facial muscles on the affected side. As bell s palsy is often associated with a viral infection, antivirals such as aciclovir may be prescribed. Failure to demonstrate any return of hemifacial tone or movement within 4 to 6 months suggests an alternative diagnosis. As bells palsy is often associated with a viral infection, antivirals such as aciclovir may be prescribed. Most people make a full recovery within 9 months, but it can take longer. People with bells palsy may be unable to generate facial expression or have an uneven or droopy appearance. In other cases, treatment may include medications and physical therapy. When evaluating a patient with facial weaknessparalysis for bells palsy, the following should be considered. Bells palsy is a relatively uncommon condition, but one that affects people across the age and sex spectrum, with incidence ranging from 11.
In some cases, only medical therapy is needed, with steroids andor antiinflammatory medication prescribed immediately after symptom onset. However, you may not have to be treated for bells palsy if your symptoms are mild. Bell s palsy is a weakness or paralysis of a facial nerve. It develops suddenly, usually on one side of the face. Other symptoms include drooping of the eyelid, a change in taste, pain around the ear, and increased sensitivity. A diagnosis of bells palsy was made and treatment with. For those with longstanding sequaelae from incomplete recovery.
Bell s palsy or idiopathic facial paralysis is the most common cause of unilateral facial paralysis. Dec 04, 2017 bell s palsy is generally temporary, and most people will recover within 9 months. Affected patients develop unilateral facial paralysis over one to three days with. Bells palsy can affect men and women of any age although the highest incidence appears to be in 1545 year olds. It affects only one side of the face at a time, causing it to droop or become stiff on that side. Bells palsy november 9, 2009 page 3 of 5 bells palsy and no muscle contraction is observed when the stim is applied, then the nerve is likely not sufficiently healed and the treatment is not recommended. Bell s palsy is essentially a diagnosis of exclusion, so once other causes of facial palsy have been eliminated, we call an isolated facial palsy bell s palsy, or idiopathic facial palsy. Bells palsy, which is the most common form of facial nerve palsy, can be a very terrifying condition for a person to have because any form of facial paralysis creates a life of traumatic experiences. Clapham, superintendant physiotherapist, wessex neurological centre, southampton general hospital sit relaxed in front of a mirror gently raise eyebrows, you can help the movement with your fingers draw your eyebrows. Bells palsy affects both men and women across a wide range of ages. Bells palsy is a weakness or paralysis of a facial nerve. Bell s palsy is idiopathic but there is weak evidence that bell s palsy is cased by herpes simplex virus.
Bells palsy, also known as idiopathic facial palsy, is a form of temporary facial paralysis or weakness on one side of the face. They may include muscle twitching, weakness, or total loss of the ability to move one or rarely both sides of the face. Bells palsy remains the most common cause of lower motor neurone facial nerve paralysis. Treatment for bells palsy is dependent on the individual. Prognosis and treatment of idiopathic facial bells palsy. Bells palsy is a condition in which the muscles on one side of your face become weak or paralyzed. Davenport rj, sullivan f, smith b, morrison j, mckinstry b. The incidence of bells palsy is 2030 cases for 100,0001 and.
Bells palsy is caused when the nerve that controls one side of the face and forehead stops working normally. Immune, infective and ischaemic mechanisms are all potential contributors to the development of bells palsy, but the precise cause remains unclear. If you cannot completely close your eye, consider using an eye patch while you sleep. May, 2020 bell s palsy, also known as idiopathic facial palsy, is a form of temporary facial paralysis or weakness on one side of the face. Use features like bookmarks, note taking and highlighting while reading bells palsy handbook. Research shows that practicing simple and easy facial exercises has been beneficial in retraining their facial muscles. Idiopathic or bells palsy cause not known but likely to be linked to herpes simplex infection tumour a tumour compressing the facial nerve can result in facial paralysis, but more commonly the facial nerve is damaged during surgical removal of a tumour. Sir charles bell described the anatomy of the facial nerve and its association with unilateral facial paralysis in 1821.
It is sometimes stated that estim can cause synkinesis in a patient recovering from bells palsy. Bells palsy is a weakness paralysis that affects the nerve fibres that control the muscles of the face. Bells palsy is rapid in onset bells palsy is diagnosed when no other medical etiology is identified as a cause of the facial weakness. Others choose to treat bells palsy during pregnancy, especially occurrences in. Oct 01, 2007 bell s palsy is a peripheral palsy of the facial nerve that results in muscle weakness on one side of the face. More detailed information about bell s palsy is available by subscription. Bells palsy usually begins with a sudden feeling of weakness or paralysis on one side of the. In addition to inability to move the muscles of one side of the face, the patient with bells palsy may present other symptoms. Bells palsy has been traditionally defined as idiopathic. Bells palsy is an idiopathic, unilateral, acute weakness of the face in a pattern consistent with peripheral facial nerve dysfunction, and may be partial or complete, occurring with equal frequency on either side of the face. This case report describes a patient referred for physical therapy evaluation and treatment.
The facial nerve fibers can implant into the different muscles in cases of bells palsy. Optimising treatment of bells palsy in primary care. Bells palsy or idiopathic facial paralysis is the most common cause of unilateral facial paralysis. Bell s palsy is a type of facial paralysis that results in an inability to control the facial muscles on the affected side. The myriad treatment options for bells palsy include medical therapy. The treatment of bells palsy in pregnancy is controversial. Most people with bells palsy recover fully with or without treatment. Though the condition is uncommon, it is the most common facial nerve disorder.
In bells palsy the facial nerve is affecied in its intratemporal course between. Early treatment with prednisolone increases the chance of complete recovery of facial function to 82%. Laboratory evaluation, when indicated by history or risk. Bells palsy is the appellation commonly used to describe an acute peripheral facial palsy of unknown cause. Bells palsy is facial nerve paralysis of unknown cause. Others choose to treat bells palsy during pregnancy, especially occurrences in the third trimester.
Bells palsy is a common cranial neuropathy causing acute unilateral lower motor neuron facial paralysis. Treatment of bell palsy using facial exercises in primary. Download it once and read it on your kindle device, pc, phones or tablets. Bell s palsy is rare in children, and most children who are affected make a full recovery without treatment. You are more likely to get bells palsy if you have diabetes, are pregnant, or are sick with a cold or the flu. This may be caused by a viral infection, but frequently no cause is found. Bells palsy is idiopathic but there is weak evidence that bells palsy is cased by herpes simplex virus. Feb 28, 2019 bell s palsy is a weakness paralysis that affects the nerve fibres that control the muscles of the face. Bells palsy should be diagnosed by a medical doctor. Bells palsy is generally temporary, and most people will recover within 9 months. There is no cure for bells palsy, but treatment can help you to get better faster, especially if you can start treatment within the first few days. Other treatment options include concomitant antiviral agents, physiotherapy, and, in severe cases, surgical decompression.
Apr 09, 2014 bell s palsy is an idiopathic, unilateral, acute weakness of the face in a pattern consistent with peripheral facial nerve dysfunction, and may be partial or complete, occurring with equal frequency on either side of the face. Bells palsy may be diagnosed after exclusion of all secondary causes, but causes of secondary facial nerve palsy and bells palsy may coexist 12. Learn more about bells palsy, which causes temporary facial paralysis. In addition, numerous diagnostic tests available are used in the evaluation of patients with bells palsy. Symptoms appear suddenly over a 48 72hour period and generally start to improve with or without treatment after a few weeks, with recovery of some or all facial function within six months. Bells palsy may occur in men, women, and children, but is more common in those 1545 years old. Education bells palsy jefferson city medical group. Recently published guidelines for the acute treatment of bells palsy advocate for steroid monotherapy, although controversy exists over whether combined corticosteroids and antivirals may possibly have a bene. This damage causes partial or total paralysis of one side of the face. Bells palsy berkshire healthcare nhs foundation trust. In fact, doctors usually find out through what they call a diagnosis of exclusion. Data suggests that the damage is a result of a viral infection along the path of the nerve. The cause is not clear but most cases are probably due to a viral infection.
Bells palsy background this plain language summary serves as an overview in explaining bells palsy. Theres no onesizefitsall treatment for bells palsy, but your doctor may suggest medications or physical therapy to help speed your recovery. The most common cause of acute onset unilateral peripheral facial weakness is bells palsy. Bells palsy bells palsy is a form of temporary facial paralysis that results from damage to the facial nerve also known as cranial nerve vii. Bell s palsy may be diagnosed after exclusion of all secondary causes, but causes of secondary facial nerve palsy and bell s palsy may coexist 12.
Read on to know more about exercises for bells palsy. Pdf treatment for bells palsy brian mckinstry academia. Bell s palsy is caused by an inflammation of the facial nerve. Bells palsy fact sheet national institute of neurological. The myriad treatment options for bells palsy include medical therapy steroids and antivirals, alone and in combination,24 surgical decompression,58 and complementary and alternative therapies such as acupuncture. Bells palsy, also known as acute peripheral facial palsy of unknown cause, can occur at any age. There was no other limb weakness or focal neurology. Bell s palsy is the appellation commonly used to describe an acute peripheral facial palsy of unknown cause.
Mri scanning can be used to exclude other causes of facial nerve dysfunction, such as facial schwannoma or acoustic neuroma. Diagnosis and management american family physician. Treatments are generally designed to improve facial function and facilitate recovery. This can happen when a nerve in your face becomes irritated. The myriad treatment options for bells palsy include medical therapy steroids. Bells palsy is paralysis or weakness of the muscles on one side of the face. Bells palsy is an acute unilateral peripheral facial. Find out why bells palsy happens and what to do about it. Left untreated, 7075% of patients make a full recovery. Corticosteroids may also be given to reduce the inflammation.
While 71% experience complete spontaneous resolution, including 61% who demonstrate a complete palsy and 94% who demonstrate a partial palsy, the remaining 29% exhibit lifelong residual hemifacial weakness. Bells palsy usc division of biokinesiology and physical therapy. Eleven people need to be treated for one extra complete recovery at six months. Bells palsy during pregnancy facial paralysis institute. Bells palsy is a form of temporary facial paralysis that can affect a persons daily function, communication with others, selfesteem, and quality of life. Oct 21, 2019 bells palsy is a form of facial paralysis due to which a person faces the inability to voluntarily control the facial muscles. The advances in understanding and treatment of this disease are especi ally due. However, the terms bells palsy and idiopathic facial paralysis may no longer be considered synonymous, as herpes simplex virus activation is. When one of the nerves is weak or paralyzed, that side of the face droops.
The 2 facial nerves control movement of the muscles of expression on each side of your face. Many of these tests are of questionable benefit in bells. Treatment for bells palsy article pdf available in the lancet 3729645. Help yourself blink by using your finger to close and open your eyelid. Using massage therapy to treat bells palsy medical. Bells palsy can make your lower eyelid droop, causing a dry eye. Synkinesis occurs secondary to abnormal facial nerve regeneration after bells palsy, or in instances where the facial nerve has been cut and sewn back together. Its believed to be the result of swelling and inflammation of the nerve that controls the muscles on one side of your face. Bell s palsy is an acuteonset peripheral facial neuropathy and is the most common cause of lower motor neuron facial palsy. Facial exercises the bells palsy association uk this leaflet reproduced with the kind permission of l. Bell s palsy, also known as acute peripheral facial palsy of unknown cause, can occur at any age. Pathogenesis, clinical features, and diagnosis in adults and bell s palsy.
The facial nerve controls many muscles of the face, including those that cause. Generally, bells palsy affects only one side of the face. Some physicians choose not treat with steroids or antivirals, especially occurrences in the first trimester. However, the terms bell s palsy and idiopathic facial paralysis may no longer be considered synonymous, as herpes simplex virus activation is the likely cause of bell s palsy in most cases. Read on for causes, risk factors, and treatment options. In bells palsy this nerve is affected, leading to weakness or paralysis of the muscles that control smiling, frowning, eating and closing of the eyelids. Bells palsy is a peripheral palsy of the facial nerve that results in muscle weakness on one side of the face. Commonly used medications to treat bells palsy include. Treatment with prednisolone should begin within 3 days 72 hours of the symptoms starting. Bell s palsy causes weakness or paralysis of the muscles. Because of this, doctors sometimes prescribe antiviral medicine to treat it. Advancements in the understanding of intraaxonal signal molecules and the molecular mechanisms underpinning wallerian degeneration. It s believed to be the result of swelling and inflammation of the nerve that controls the muscles on one side of your face. Bells palsy is rare in children, and most children who are affected make a full recovery without treatment.
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