Diagnosing & Treating Bell’s Palsy
Bell’s palsy results from dysfunction of the seventh cranial nerve, which directs the muscles on side of the face. These muscles control eye blinking and closing and facial expressions such as smiling. This particular facial nerve also carries nerve impulses to the tear glands, the salivary glands and the muscles of a small bone in the middle of the ear. It also transmits taste sensations from the tongue. Although Bell’s palsy is the most common cause of facial paralysis its cause remains unknown.
Bell’s palsy tends to affect only one side of the person’s face. In rare cases, both sides of the face may be afflicted. Symptoms appear suddenly over a 48 – 72-hour period and generally start to improve after a few weeks, with full recovery of some or all facial function within six months. In some people, the residual muscle weakness may last longer than anticipated and there is slim possibility of permanent muscle weakness as well. Bell’s palsy can affect any gender and age but seems to be highest in the 15- to 45-year-old group.
Risk factors include pregnancy, pre-eclampsia, obesity, hypertension, diabetes and upper respiratory ailments.
Diagnosing Bell’s Palsy
To diagnose, the doctor will examine the affected side for upper and lower facial weakness. In most cases this weakness occurs to both upper and lower facial muscles, including forehead, eyelid and/or mouth.
Routine laboratory or imaging studies are not necessary, but sometimes can confirm the diagnosis or rule out other diseases that can cause facial weakness. A test called electromyography (EMG) can confirm the presence of nerve damage and determine the severity and extent of the nerve involvement
Is Bell’s Palsy Treatable?
To treat, your doctor may order steroids which are likely to be effective and can increase the probability for the recovery of facial and nerve function. Analgesics such as aspirin, ibuprofen, or acetaminophen may relieve pain. Because of possible drug interactions, individuals taking prescription drugs should always check with their physician before taking over the counter medications.
Bell’s palsy can interrupt the eyelids natural eye-blinking ability. Keeping the eye moist and protecting it from debris and injury–especially at night–is necessary. Artificial tears, gels or ointments along with eye pads are also effective.
Your doctor may choose to order other therapies as well, such as physical therapy, facial exercises, massage or acupuncture which may provide some improvement in facial function and pain.
Clinical evidence shows individuals experience improvement within 3 weeks and most eventually recover normal function.
For More Information
As unpleasant as it is, the prognosis is generally good for people recovering from Bell’s palsy. If you suspect you may have Bell’s palsy, the first step is to get a professional diagnosis from Dr. Dulai . Second, be informed about this disorder by reviewing our Patient Education page for symptoms, diagnosis, treatment and resources. Call for an appointment with Neurology Associates at either the Dulles or Lansdowne offices at 703-726-6393.