When people experience weakness on one side of their face, they automatically think of stroke. But if the symptoms are only affecting your face and no other part of your body, your paralysis may be due to Bell’s Palsy.
Bell’s Palsy is a condition that causes temporary weakness of one side of the face—noticeable by the inability to smile or keep your eye on that side closed. The condition is named after Sir Charles Bell who presented cases in 1829. The symptoms usually come on suddenly, for no apparent reason. But prior to the full onset of symptoms, you may notice you have trouble closing your eye (causing your eyes to water) and that you are drooling on one side. You may even experience a pain behind your ear. Although there are not always warning signs, you may just wake up with a drooping mouth and an eye that doesn’t close. In severe cases you may also experience pain in the jaw, headaches, and a change in your taste buds.
The exact cause of Bell’s Palsy is unknown but most doctors believe it is due to damage to the seventh cranial nerve, which controls the muscles of the face. The damage to the nerve results in swelling, causing pressure on the nerve as it leaves the skull to the face through a narrow opening. This pressure affects the nerve signal reaching the muscles, resulting in paralysis. The cause of the damage is, however, still under discussion but many sources believe a viral infection may be the cause. There are also risk factors like diabetes, an upper respiratory tract infection, such as a cold or the flu, and pregnancy that can increase the risk of developing the condition.
Diagnosing Bell’s Palsy is usually straightforward but if your doctor suspects a stroke, infections, Lyme disease or tumours, all of which have similar symptoms, then they may request further tests. The most effective tests to differentiate between the different conditions are CT or MRI scans, or an EMG test which can determine the severity of the nerve damage. There is no cure for Bell’s Palsy and most people can expect to recover fully, although it can take from a few weeks to several months. The emphasis is on managing the symptoms through medication and, in some cases, physiotherapy.
The purpose of medication is to reduce the inflammation and the most effective drugs are corticosteroids like prednisolone which is a powerful anti-inflammatory. Physiotherapy can be effective in the management of weakness, pain and inflammation, if present, by the use of electrotherapy, exercise and massage. Therapeutic massage to maintain the flexibility and length of the facial muscles, which may shorten, can prevent permanent contractures developing. In extreme cases where the pressure is not relieved and symptoms worsen, decompression surgery may be indicated.
Self-care is important to avoid complications. Not being able to close your eye can lead to a condition called dry eye syndrome which can cause burning, itchy, tired eyes that are sensitive to light. The best way to avoid this secondary complication is to use a lubricant to keep the eye moist, wear glasses and frequently close the eye with your hand. At night, to avoid damage or accidentally getting something in the eye, you can wear an eye patch or tape the eye closed.
It can be a frightening experience but the most important thing to remember is that, in most cases, the symptoms are only temporary and full recovery will take place with or without treatment. Timely treatment minimises the risks of long-term complications and may help to speed up recovery.
If you are still worried, knowing that some of the most beautiful and famous people have experienced the condition may help to relieve your fears; among them are Angelina Jolie, once voted the world’s most beautiful woman by Vanity Fair; George Clooney whose smile makes women swoon; Pierce ‘James Bond’ Brosnan, and Empire star Terence Howard. The take-home message is: keep smiling and stay positive.
Kim Jackson is a UK-trained physiotherapist with over 20 years’ experience. She specialises in musculoskeletal pain and dysfunction including back pain and sciatica, stroke and other neuro conditions plus sports physiotherapy, having worked with local, regional and international athletes and teams treating injuries and analysing biomechanics to improve function and performance. She is registered with the Allied Health Council and is a member of PASL. She currently works at Bayside Therapy Services in Rodney Bay, O: 458 4409 or C: 284 5443; www.baysidetherapyservices.com
