Facial palsy: What is it?
In general, facial palsy occurs when the facial nerve has been temporarily or permanently damaged, resulting in weakness of the facial muscles. Damage to the facial nerve itself or to the brain area controlling the nerve’s function can result in weakness or total loss of movement of the mimic muscles. Generally, facial palsy affects only one of the paired facial nerves, in which case only one side of the face becomes paralyzed.
Bell’s palsy
Disorders of the functioning of the facial nerve can manifest themselves as facial palsy. When mimic muscles become paralyzed, they can’t move and the affected half of the face becomes motionless and expressionless. A person suffering from facial palsy may not be able to lift the eyebrow on the affected side, has difficulty closing the eye, and may experience drooping of the corner of the mouth. Facial functions such as eating, drinking, and speaking become difficult. People with facial disfigurement as a result of facial palsy also suffer a great deal of psychological distress.
Bell’s palsy is the most common form of acute facial palsy. It is named after Charles Bell, a surgeon who studied facial paralysis 200 years ago. The term Bell’s palsy is given to the conditions where the exact cause of the facial palsy is not known. Though a clear-cut reason for Bell’s palsy has not yet been established, some theories suggest that the reactivation of herpes viruses in the facial nerve might be responsible for the condition.
For example, it is thought that inflammation will cause swelling in the facial nerve. When the facial nerve swells, it gets jammed in its tiny bony canal inside the skull, suffers from ischemia, and becomes unable to send signals to the mimic muscles to contract. As a result, mimic muscles become paralyzed on the side of the face where the facial nerve has been affected.
Symptoms of facial palsy can range from mild to severe, from facial weakness with partial loss of voluntary facial movements (paresis) to complete loss of facial movements (paralysis) on the affected side. In complete facial paralysis, strong facial asymmetry can make the face look significantly distorted.
Prognosis of Bell’s palsy
Bell’s palsy typically develops within a few hours or overnight. Anyone who becomes afflicted should seek medical care without delay. Bell’s palsy is usually temporary and has a good recovery rate: approximately 70% of patients will have recoveries within a few weeks to a few months after onset. Even though most patients recover, recovery is sometimes incomplete and some weakness may continue or abnormal facial movement patterns may develop.
It is difficult to predict the future recovery during the first days of Bell’s palsy. That is why it is important to do everything possible immediately after onset to ensure each patient reaches as complete a recovery as possible. Immediate medication and appropriately designed long-term rehabilitation carried out with dedication are notable treatments for Bell’s palsy.
Medical Treatment of Bell’s palsy
It is necessary that a person with Bell’s palsy is examined and medicated at first by a physician familiar with the disease. Treatment of acute Bell’s palsy is initially medical, and medication must be undertaken without delay within two days of the emergence of symptoms. Doctors typically prescribe oral anti-inflammatory and antiviral medication. Corticosteroids have been shown in many studies to reduce inflammation and swelling of the facial nerve, which should minimize nerve compression and damage. According to the herpes virus theory, antiviral drugs are often added to the medication to tame the herpes virus.
The treatment may be enhanced by taking vitamins B, especially B 12, omega-3 fish oils, and other possible dietary supplementation under the supervision of a physician. Eye care is a very important part of treatment when a patient with Bell’s palsy cannot close the eye properly. Both eye drops which work as artificial tears and lubricant ointments keep the eye moist, thus preventing the surface of the eye from drying out. Sometimes it is necessary to wear an eye patch and tape the eye shut while asleep.
Facial palsy due to a Stroke
Bell’s palsy is caused by a problem in the facial nerve itself. Symptoms of facial palsy may be caused by conditions other than Bell’s palsy. A serious cause is a stroke. If a blood vessel in the brain gets clogged or bursts, the brain becomes damaged, and if the part of the brain that controls the function of the facial nerve is damaged, it leads to the paralysis of the muscles on one side of the face.
When a stroke is the cause of facial paralysis, the person may still be able to raise both eyebrows and close both eyes, unlike in the case of Bell’s palsy. With a stroke, other muscles on the same side of the body are also involved. Stroke often spares involuntary, emotional facial movements such as spontaneous smiling, because these functions are controlled by areas of the brain that are not affected.
A person having any stroke symptoms should be taken immediately to the hospital’s emergency unit in an ambulance. Every minute matters. Never just wait and see if the symptoms go away. It is normal that the symptoms may fluctuate, and it is common that there is no sensation of pain. The earlier the treatment begins, the greater the chances are that the person having a stroke will receive treatment that can minimize the long-term consequences of the stroke.
If a clot-dissolving medication is given in the case of a blood clot within three hours of the first symptoms, it may reduce the long-term disability of this most common type of stroke. Ideally, the person having signs of a stroke should be in the emergency room within 60 minutes of the first symptoms. Rehabilitation of facial palsy due to a stroke is a part of the medical rehabilitation of all the resulting disabilities.
A multi-professional team consisting of the treating neurologist and physical, speech and occupational therapists specialized in neurological rehabilitation provide comprehensive support for the patient suffering from a stroke. Facial palsy due to a tick bite Lyme disease is a bacterial infection that can cause facial palsy. Lyme disease got its name from the town of Old Lyme in the United States, where the disease was first reported in 1975.
Everyone can get Lyme disease if bitten by a tick carrying borrelia bacteria. Symptoms begin days or weeks after the tick bite. They are similar to the flu and there might be a little redness around the area of the bite. If not treated in the early stage, borrelia infection may spread to the nerves and joints, causing symptoms weeks to months after the initial bite.
Paralysis or weakness in the muscles of the face may be one of the symptoms. Unlike most forms of facial palsy, facial paralysis associated with borrelia infection can be prevented by early treatment with antibiotics taken in the first stage while there are only a few early symptoms revealing the existence of Lyme disease.
Learn to Recognize Stroke Symptoms
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Sudden numbness or weakness of the face, arm, or leg on one side of the body. It can be a sign of a stroke if one side of the mouth suddenly droops when the person tries to smile, or if suddenly one arm begins to fall when a person tries to raise both arms over the head at the same time.
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Sudden trouble speaking and understanding simple statements, slurred speech, or inability to find the words. If a person is suddenly unable to repeat a simple sentence, he or she might have had a stroke.
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Sudden trouble seeing with one or both eyes, blurred, double, or blackened vision.
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Sudden trouble with walking. A person may suddenly begin to stumble or experience sudden dizziness and loss of balance or loss of coordination.
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Symptoms of a stroke are often painless, but sometimes a sudden severe headache with no apparent cause and different from previous headaches is a sign of a stroke. The headache may be accompanied by vomiting, dizziness, or altered consciousness.
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