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Facial Paralysis

Facial Paralysis

Definition

Bell’s palsy is a sudden weakness or paralysis on one side of the face. It is usually a temporary condition.

Bell’s Palsy: Facial Droop
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Causes

The exact cause of Bell’s palsy is unknown. It is thought to be a result of an infection or inflammation that affects the nerve.

Examples include:

  • Lyme disease
  • Herpes simplex
  • Shingles or chickenpox

Risk Factors

Factors that may increase your risk of Bell’s palsy include:

  • Family members who have Bell’s palsy
  • Diabetes
  • Autoimmune disorders
  • Infections, such as Lyme disease, HIV, cold, or flu
  • Suppressed immune system
  • Chemotherapy
  • Certain medications
  • Pregnancy
  • Smoking
  • High blood pressure

Symptoms

Bell’s palsy symptoms may come on suddenly or develop over a few days. Initial symptoms may include:

  • Pain behind the ear that is followed by weakness and paralysis of the face
  • Ringing sound in the ears
  • Slight hearing impairment
  • Slight increase in sensitivity to sound on the affected side

Symptoms of advanced Bell’s palsy may include:

  • Facial weakness or paralysis, most often on one side
  • Numbness just before the weakness starts
  • Drooping corner of the mouth
  • Drooling
  • Decreased tearing
  • Inability to close an eye, which can lead to:
    • Dry, red eyes
    • Ulcers forming on the eye
    • Infection
  • Problems with taste on one side
  • Sound sensitivity in one ear
  • Earache
  • Slurred speech

Late complications can occur 3-4 months after onset and can include:

  • Long-lasting tightening of the facial muscles
  • Tearing from eye while chewing

Symptoms will often go away on their own within a few weeks. Bell’s palsy may resolve after a few months in many people. In some cases, some symptoms of Bell’s palsy may never go away. The recovery rate decreases with increasing age.

Diagnosis

Physicians will attempt to differentiate between between Bell’s palsy and other causes of facial weakness (including stroke and tumor). You will be asked about your symptoms and medical history. A physical exam will be done. The diagnosis is usually made with just the physical exam. Information from your health and medical history may be used to determine a potential cause.

Concern about infections, cancer, or other specific causes may require further testing. Tests may include:

  • CT scan
  • MRI scan
  • Lumbar puncture

Treatment

For Bell’s palsy, treatment most frequently involves medications. You may be referred to a specialist if you have eye problems, if your symptoms worsen, or if your recovery takes longer than expected.

If the facial weakness is due to a cause other than Bell’s palsy, treatment for underlying conditions may include medication or surgery.

Prevention

There are no current guidelines to prevent Bell’s palsy.

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