Bell's Palsy

GENERAL INFORMATION:

What is Bell's palsy? Bell's palsy is a sudden weakness or paralysis (pah-RAL-i-sis) of one side of the face. This may happen when the nerve that controls your face muscles (facial nerve) becomes swollen or irritated. Bell's palsy symptoms may range from mild to severe (very bad). The weakness or paralysis (lack of movement) that is the main symptom of Bell's palsy usually goes away on its own. It may take a few weeks to several months for your Bell's palsy to get better. Most people have no long-lasting symptoms of Bell's palsy once it gets better. Some people may recover and then have Bell's palsy again months or years later. Some people may have life-long problems.

What causes Bell's palsy?

• It is not known for sure what causes the facial nerve swelling that leads to Bell's palsy. Scientists think that the herpes simplex virus may cause the swelling in some cases. This is the same virus that causes cold sores (fever blisters), and sometimes causes sores elsewhere on the body.
  
  
• Bell's palsy happens in both men and women. Bell's palsy occurs more often in people after they have had an infection (in-FEK-shun) like a cold or the flu. Pregnant women, and people who have diabetes or immune system problems are also more likely to get Bell's palsy.

Signs and symptoms: The symptoms of Bell's palsy often occur suddenly. Some people may notice pain around one ear a day or two before having other symptoms. A few days later, weakness may appear on the same side of the face as the ear pain. The symptoms often increase (get worse) over the following several days. Bell's palsy usually lasts at least two or three weeks, but can last several months. You may have one or more of the following signs and symptoms with Bell's palsy:

• Weakness or paralysis on one side of the face.
  
  
• Drooping of one side of the face.
  
  
• Trouble closing your eye on the affected side of the face.
  
  
• More sensitive hearing on the affected side.
  
  
• Numbness or pain in the ear, tongue, or face.
  
  
• Unable to taste with the tip of your tongue. Food may not taste the same because of this.
  
  
• Changes in the amount of tears and saliva (spit) you make.
  
  
• Problems with chewing foods or whistling.

How is Bell's palsy diagnosed?

• Physical examination: Your caregiver will test how well you can move different parts of your face. You may not need any other tests before you are diagnosed with Bell's palsy.
  
  
• EMG: This test is also called electromyography (ee-lek-troh-meye-OG-rah-fee). It measures the electrical activity of your muscles. An EMG also tests the nerves that control muscles. You may need an EMG if your Bell's palsy is bad or does not go away.
  
  
• Other tests: Your caregiver may need to do tests to rule out other causes of your signs and symptoms.

How is Bell's palsy treated? Bell's palsy often goes away without treatment. Some treatments may help you get better faster. Some treatments may help you avoid other problems that may happen because of your Bell's palsy. Your treatment may include one or more of the following:

• Eye care: You will need to take special care of your eye if you have problems blinking or closing your eye. Use artificial tears during the day to keep your eye moist. These can be bought at a grocery or drug store. Your caregiver may ask that you use a special eye ointment at night. You may need to use an eye patch or wrap-around goggles to protect your eye from irritants such as dust. You may need to tape your eye shut while you sleep. Wear sunglasses to protect your eye from direct sunlight. Stay away from places that have fumes, dust, or other particles in the air that may harm your eye.
  
  
• Medicines: Medicine may help decrease the severity of your symptoms, or the length of time that you have them. Medicines have a better chance of helping if they are given during the first 24 hours of Bell's palsy symptoms. You may also need medicine to help you with pain or discomfort. Your medicines may include:
  
  
  • Antiviral medicine: Antiviral (an-teye-VEYE-ral) medicine may be given if your caregiver thinks that a virus may be causing your Bell's palsy. Viruses are germs that can cause an infection or other problems in the body.
    
    
  • Anti-inflammatory medicine: Your caregiver may give you an anti-inflammatory medication called a steroid. Steroids are given to decrease swelling and irritation of the facial nerve.
    
    
  • Pain medicine: You may need ibuprofen (eye-bu-PROH-fen) or acetaminophen (a-seet-a-MIN-oh-fen) if you have pain. Tell caregivers if your pain does not decrease enough for you to feel better. Take this medicine when your pain begins. Do not wait to take pain medicine until the pain is very bad. The medicine may not work as well at controlling your pain if you wait too long to take it.
  
  
• Physical therapy: A physical therapist can teach you ways to decrease your Bell's palsy signs and symptoms, and prevent long-lasting problems. You may learn how to massage your face to keep the muscles in good shape. You may also learn exercises to help your nerves and muscles. You can exercise on your own when your facial movement begins to return. Open and close your eye, wink, and smile wide. Do the exercises for 15 or 20 minutes several times a day.
  
  
• Relaxation therapy: This step-by-step therapy teaches you how to calm your body and mind. The goal is to feel less physical (body) stress and have less emotional (mind) stress. Ask your caregiver for more information about ways to relax and decrease stress.
  
  
• Surgery: It is rare to need surgery for Bell's palsy. You may need surgery to decrease pressure on your facial nerve if your symptoms are severe or do not go away. You may need surgery if you have problems that do not go away, such as an eyelid that will not completely close.

Risks: If your Bell's palsy symptoms are mild, they usually last for about two to three weeks. If you have more severe symptoms, such as paralysis, it may take months for you to recover. Problems with facial movement or drooping may be permanent (life-long). If your eye does not close completely and you do not protect it, you may have vision problems.

For more information: Contact the following organization for more information on Bell's palsy:

• • National Institute of Neurological Disorders and Stroke
    P.O. Box 5801
    Bethesda, MD 20824
    Phone: 1-800-352-9424
    Web Address: http://www.ninds.nih.gov
    
  
  
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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