Bell’s palsy: beware of stress and cold

Bell’s palsy is an ailment that causes impermanent weakness or paralysis of the facial muscles. It happens when the nerve controlling the facial muscles develop inflammation, swelling or compression.

Most often, it is caused due to exposure to a viral infection. Bell’s palsy comprises a virus that causes cold sores and genital herpes (herpes simplex), chickenpox and shingles (herpes zoster).

Bell’s palsy symptoms develop within a week or two after catching cold, ear infection or eye infection, and are noticed only when the person tries to eat or drink. The illness is temporary and will gradually go away by six weeks. It commonly affects people who have diabetes or those recuperating from viral infections.

Bell’s palsy may happen at any age; however,those between ages 16 to 60 are more susceptible. The ailment is named after Scottish anatomist Charles Bell who described the symptom for the first time.

Facial nerve damage

Medical experts believe that stress weakens the immune system and damages the seventh cranial nerve (or the facial nerve) which causes facial paralysis.

The condition causes one side of your face to droop or become stiff. A Bell’s Palsy patient will face trouble in smiling or closing the eye on the affected side.

The seventh cranial nerve passes through a narrow, bony area inside the skull. In case of even minimal swelling in the nerve, it ends up touching against the skull’s hard surface. This impacts on the smooth work flow of the nerve.

The seventh cranial nerve surfaces from the brainstem pons controlling the muscles of facial expression. It functions in the transmission of taste sensations to two-thirds of the frontal tongue and detection of flavours through special sensory fibres.

It maintains motor function of the facial muscles allowing expressions like smiling and frowning along with function of glands in the mouth, eyes and nose.

Facial nerve damage can affect any or all of these areas or functions. The symptom related to the eye can be somewhat upsetting. There could be sharp pains in the eye or blurred vision, the eyelid functioning is impaired, affecting the shutting of the eye during sleep.

Bell’s palsy increases the sensation to sounds. Sounds seem very loud on the ear on the affected part of the face. Bell’s palsy includes the following virus/bacteria:

• Herpes simplex, which is responsible for cold sores and genital herpes

• HIV, where in the immune system is damaged

• Sarcoidosis, causing organ inflammation

• Herpes zoster virus, responsible for chickenpox and shingles

• Epstein-Barr virus, which causes mononucleosis

• Lyme disease, caused by ticks infected by the bacteria

Diagnosis

The doctor will check the closure of the eyelid to diagnose Bell’s palsy along with a test for hearing and sense of balance. On confirmation of the ailment, the doctor is likely to recommend a skull X-ray or magnetic resonance imaging(MRI) to offer clarity on the time taken for a complete recovery.

Bell’s palsy is usually treated with corticosteroids as they have a strong anti-inflammatory action to minimise the nerve damage and improve the outcome. The objective is to reduce the swelling of the facial nerve.

Usually patients with Bell’s palsy recover fully without any treatment. The time of recovery depends on the severity of the nerve damage and the individual’s capacity.

People with Bell’s palsy have be cautious in protecting the eye on the affected side. While sleeping, they have to wear an eye patch as the eyelid will not shut on its own as a result of which the chances of foreign particles entering into the eye are high.

Eye drops have to be used to keep the eye moist as there will be a reduction of tear, and drops will prevent the eye from drying out.

Home treatment

• Eye patch (for dry eye)

• Warm, moist towel over your face to relieve pain

• Facial massage/ physiotherapy

• Physical exercises to stimulate your facial muscles

If you feel like you are experiencing any symptom of Bell’s palsy, reach out to the nearest doctor/hospital at the earliest. Immediate treatment can help speed up your recovery time and prevent any complications.

(The writer is consultant neurologist, Columbia Asia Hospital, Hebbal)