Understanding Bell’s Palsy

March 27, 2023 | Raquel Paz Bergia | Neurology

Bell’s Palsy is an unexplained episode of paralysis in one half of the face. It affects both women and men equally and tends to worsen over 48 hours. It is uncommon between the ages of 15 and 60. Usually, it is not permanent, but in some rare cases, it doesn’t go away. Most people recover full facial strength and expression in less than 6 months. Neurological epidemiology is damage to the facial nerve, the 7th nerve.

This article provides insight into the etiology (causes), the physiological effects, the neuropathology, and the management of Bell’s Palsy.

What is Bell’s Palsy?

Bell’s Palsy is an acute unilateral peripheral facial paralysis caused by damage to the 7th nerve; the facial nerve. Hence, it affects the movement of half of the face, resulting in paralysis and loss of facial expression. Moreover, patients with Bell’s Palsy have a prognosis that is very hopeful. Most cases of this disorder are resolved within 6 months, however, in rare cases, it can result in permanent nerve damage. Overall, this disorder causes uncomfortable sensations because of numbness in the face.

What is the epidemiology of Bell’s Palsy?

Bell’s Palsy has an unknown cause, however, it is believed that it is due to inflammation in the area of control of the facial nerve. Bell’s Palsy can be associated with all the following:

  • High blood pressure
  • Injury
  • Toxins
  • Lyme Disease
  • Diabetes
  • Multiple Sclerosis
  • Infection (mainly after a viral infection)

These can be associated with Bell’s Palsy, but they are not a direct cause. People with disorders that are associated with Bell’s Palsy are more likely to experience it at some point due to the area being damaged. Moreover, if experiencing any symptoms of numbness or lack of movement in the face, reaching out to a professional will help control symptoms.

Bell’s Palsy and the House-Brackmann Facial Paralysis Scale

The House-Brackmann Facial Paralysis Scale is one used to evaluate facial paralysis at the nerve stem; it is not a descriptive scale. Doctors use this to evaluate the severity of the nerve damage that is resulting in Bell’s Palsy. However, once the severity is located, more assessments need to be done to evaluate the symptoms.

  • Grade I – Normal
  • Grade II – Mild Dysfunction
  • Grade III – Moderate Dysfunction
  • Grade IV – Moderately Severe Dysfunction
  • Grade V – Severe Dysfunction
  • Grade VI – Total Paralysis

This scale can help neurosurgeons and plastic surgeons evaluate where and what is damaged. This can help with what treatments to use and how to help the patient.
What are the treatments for Bell’s Palsy?

There is no one-size-fits-all treatment for Bell’s Palsy because most patients fully recover with or without treatment. However, corticosteroids are a common treatment for Bell’s Palsy. It is usually a non-invasive solution that doctors prescribe. On the other hand, it isn’t always necessary to be using steroids and these sorts of medications for a “self-curating” disease. If you have Bell’s Palsy and want to proceed with medications, going to a professional will help ensure proper treatment.

Where can you learn more about Bell’s Palsy?

Currently, there aren’t many associations that are made specifically for Bell’s Palsy. However, organizations, such as The National Organization for Rare Disorders (NORD) and The American Association of Neuromuscular and Electrodiagnostic Medicine, support and help create awareness of Bell’s Palsy.

Conclusion

Bell’s Palsy is a unilateral facial paralysis caused by damage to the facial nerve. It has a good prognosis because in most cases it is resolved in between 2 weeks and 6 months. It is considered rare but is treatable. Bell’s Palsy may be uncomfortable, but over time the symptoms will fade away.