Bell’s palsy

Bell’s palsy is a disease characterized by acute inflammation of the facial nerve, resulting in weakness of the muscles it innervates.The incidence is about 25 cases per 100 thousand population per year. People affected by the illness are not able to control their mimics and emotions. They can’t smile, raise eyebrows or even chew meals as they used to. Moreover, the face becomes dissymmetrical and wry.

Besides, patients have problems with tearing and salivation due to suppression of parasympathetic effects. The maximum severity of the symptoms is the first 2-3 days, and the disturbance of Bell’s palsy of chronic pain correlates with the duration of facial muscle dysfunction, the range of functional recovery and impaired quality of life. As a rule, a neurologist specializes in treating this disorder.

Bell’s palsy causes

The most spread reasons for Bell’s palsy are:

As a rule, in 75% of cases, its cause remains unknown (idiopathic facial neuropathy or Bell’s palsy). However, it’s assumed that this disorder is associated with an infectious factor.

Defeat with the herpes virus, which lives in the body of most people and doesn’t betray its presence in any way. But when immunity decreases, the virus actively multiplies, resulting in inflammation and swelling of the nerve;
Hypothermia, in the case of neuritis of the facial nerve, local hypothermia is especially dangerous. For example, you have been in a draft for a long time. In such a situation, there develops a spasm of blood vessels and muscles, which contributes to a violation of the nerve nutrition and inflammation;
Volumetric formations of the brain and apoptosis, which are regulated by local direct and indirect reactions of the axon to the virus itself with a favorable phenotype;
Traumatic brain injury.

Among patients with symptoms of Bell’s palsy, a high percentage are people with diabetes mellitus. Ones who suffer from arterial hypertension are also at risk of developing this illness.

Symptoms of Bell’s palsy

Generally, there are several points which characterize Bell’s palsy:

develops acutely, most often — within a few hours (less often 1-3 days). Slowly increasing weakness of the facial muscles (over weeks or months) isn’t typical, most cases have neoplastic forms;
unilateral paresis (weakness) of all muscles innervated by the facial nerve;
in half of cases, Bell’s palsy of chronic pain begins with pain behind the ear, which can sometimes radiate to the back of the head or face;
aching and burning ache;
watery or dry eyes;
distorted, unpleasantly enhanced perception of sounds from the diseased side;
violation of taste sensations in the front 2/3 of the tongue on one side.

Nearly 75% of Bell’s palsy patients describe pain around one of the ears. If facial pain is associated with sensory disturbances and hearing loss, there is a risk of developing a parotid salivary gland tumor or viral otitis. Other complaints include hyperacusis due to disturbance of the stirrup muscle innervation, changes in taste and dryness of the mouth caused by parasympathetic dysfunction. Some patients notice facial paresthesias.

Treatment of Bell’s palsy

Clinical examination should be both neurological and general medical according to Bell’s palsy causes, including otoscopy, examination of the skin, EMG and parotid gland. The presence of vesicles around the ear requires rapid diagnosis of herpes.

Variants of possible treatment of Bell’s palsy:

corticosteroids;
antiviral medicines;
physiotherapy;
surgery.

Approximately 70% of such patients with Bell’s palsy recover completely without any therapeutic intervention. Among those who have not fully recovered, half will have minimal consequences and half will have moderate consequences.