Jaime Mitchell

26 April 2008

Bell’s Palsy

Damage to one of two facial nerves can possibly result in temporary

paralysis of the facial muscles, most often to only one side of the face and in
rare cases, both sides. This condition is known as Bell’s Palsy. The facial
nerve that is damaged is called the seventh cranial nerve. This nerve primarily
moves the facial muscles, controls the salivary and tear glands, and enables the
front part of the tongue to detect tastes. The paired seventh cranial nerve is
located in the Fallopian canal in the skull, inferior to the ear and is connected
to the muscles on the face bilaterally. As well as controlling facial muscles and
some glands, it is also responsible for letting one open and close their eyes.
Damage from swelling, inflammation, or compression to the seventh cranial nerve
ultimately results in the disruption of messages from the brain to the facial
muscles.
The cause for Bell’s Palsy is unknown. It is thought that viral infections
or damage to the myelin sheath of the seventh cranial nerve can bring on the
disorder. Viral infections may lead to inflammation, which in turn places pressure
on the Fallopian canal leading to an infarction. Damage to the myelin sheath of
the nerve can cause the disruption or slowing of signals from the brain to the
facial muscles. It is also believed that the disorder can be brought on by
patients with Lyme disease, diabetes, high blood pressure, tumors, HIV,
chickenpox, or even trauma to the face or skull near the nerve. It is possible
that anyone, at anytime can be afflicted with

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Bell’s Palsy, but those primarily susceptible include pregnant women and those
with diabetes or upper respiratory ailments such as the cold or flu. Also, young
and middle aged adults are more likely to be affected. It is quite uncommon to
see a case in an individual ten or younger and sixty or older. Roughly, forty
thousand Americans are diagnosed with Bell’s Palsy each year and 20-30 per one
hundred thousand cases are reported worldwide annually.
Bell’s Palsy is diagnosed based on clinical presentation and by the ruling
out other possible causes of facial paralysis. A visual exam including that of
the ears, sinus, and throat is performed and a physician may also compare the
right and left voluntary and involuntary movements of the face. During a visual
and physical examination, the physician will observe whether the patient exhibits
severe dryness or has difficulty completely closing and opening one eye, and
ultimately, drooping of one side of the face compared with the other. The
physician may also question whether or not the patient has trouble tasting, if
sounds are perceived louder in one ear comparably, or if there is an unusual
increase in saliva produced. Radiographic images may also be administered to rule
out tumors and presence or severity of nerve damage. These images may also rule
out the possibility of other causes of pressure on the facial nerve. As well as
the use of radiographic images, visual and physical exam, the physician may also
order blood or cerebrospinal fluid tests to rule out a bacterial or viral
infection.
The treatment for Bell’s Palsy can take several different courses.
Eliminating the source of nerve damage is the primary focus. Since, Bell’s Palsy
is different in each patient’s case, the disorder may either go away on its own in
milder cases and in the more

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extreme ones, require drug and, or physical therapy. If the cause of damage to
the nerve
is inflammation due to viral or bacterial infections, the source of recovery would
be through antiviral or antibiotic medications. Prednisone may work in
conjunction with these medications to reduce inflammation, thereby preventing
further damage to the nerve and by possibly eliminating some of the symptoms
involved. Administration of vitamins that promote nerve growth may also be given.
Stimulation of the nerve through physical therapy may also improve symptoms and
help with facial tone. Forms of physical therapy may include massages,
acupuncture, electrical stimulation, and biofeedback training. Massage therapy
can also prevent permanent contractures, that may cause deformity, before recovery
takes place.
It is important that the eye is protected when one is diagnosed, because
normal lubrication is not being provided and damage to the eye may occur.
Usually, one is given an eye patch and eye drops for this.
Although, it is uncommon, patients may suffer from weakness or paralysis to
the side of the face affected after their recovery. Involuntary twitching of the
facial muscles may occur or normal facial expressions may be accompanied by
spasms. In even rarer cases, the disorder could recur on the same or opposite
side of the face. Most, recover completely with no residual effects in one to
three months, and in some cases as short as two weeks. Ultimately, the
determination of recovery time is based on severity of damage to the nerve.

Works Cited

“Bell’s Palsy Fact Sheet.” Bell’s Palsy Fact Sheet: National Institute of
Neurological

Disorders and Stroke. Apr. 2003. National Organization for Rare Disorders.

25 Apr. 2008 <http://www.ninds.nig.gov>

Goodman, Micheal MD. “Bell’s Palsy.” Teens Health. Aug. 2007. Nemours
Foundation.

25. Apr 2008 <http://www.kidshealth.org>

Mayo Clinic Staff. “Bell’s Palsy.” Mayoclinic.com. 2 Feb. 2008. Mayo Foundation
for

Medical Education and Research. 25 Apr. 2008 <http://www.mayoclinic.com>

Tiemstra, JD, and N KhatKhate. “Bell’s Palsy: Diagnosis and Management.”

American

Family Physician 76.7 (Oct. 2007). 25 Apr. 2008 <http://www.aafp.org>