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Bells Palsy

Bell's palsy
Bellspalsy.JPG
A person attempting to show his teeth and raise his eyebrows with Bell's palsy on his right side (left side of the image; notice how the forehead is not spared).
Specialty Neurology
Symptoms Inability to move the facial muscles on one side, change in taste, pain around the ear
Usual onset Over 48 hours
Duration <6 months
Causes Unknown
Risk factors Diabetes, recent upper respiratory tract infection
Diagnostic method Based on symptoms
Similar conditions Brain tumor, stroke, Ramsay Hunt syndrome, Lyme disease
Treatment Corticosteroids, eye drops, eyepatch
Prognosis Most recover completely
Frequency 1–4 per 10,000 per year
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Bell's palsy is a type of facial paralysis that results in an inability to control the facial muscles on the affected side. Symptoms can vary from mild to severe. They may include muscle twitching, weakness, or total loss of the ability to move one or rarely both sides of the face. Other symptoms include drooping of the eyelid, a change in taste, pain around the ear, and increased sensitivity to sound. Typically symptoms come on over 48 hours.

The cause of Bell's palsy is unknown. Risk factors include diabetes and a recent upper respiratory tract infection. It results from a dysfunction of cranial nerve VII (the facial nerve). Many believe that this is due to a viral infection that results in swelling. Diagnosis is based on a person's appearance and ruling out other possible causes. Other conditions that can cause facial weakness include brain tumor, stroke, Ramsay Hunt syndrome, and Lyme disease.

The condition normally gets better by itself with most achieving normal or near-normal function.Corticosteroids have been found to improve outcomes, while antiviral medications may be of a small additional benefit. The eye should be protected from drying up with the use of eye drops or an eyepatch. Surgery is generally not recommended. Often signs of improvement begin within 14 days, with complete recovery within six months. A few may not recover completely or have a recurrence of symptoms.

Bell's palsy is the most common cause of one sided facial nerve paralysis (70%). It occurs in 1 to 4 per 10,000 people per year. About 1.5% of people are affected at some point in their life. It most commonly occurs in people between ages 15 and 60. Males and females are affected equally. It is named after Scottish surgeon Charles Bell (1774–1842), who first described the connection of the facial nerve to the condition.


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