Bell’s palsy

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Overview

Bell's palsy is a condition that causes sudden weakness in the muscles on one side of the face. In most cases, the weakness is temporary and significantly improves over weeks. The weakness makes half of the face appear to droop. Smiles are one-sided, and the eye on the affected side resists closing.

Bell's palsy, also called facial palsy, is a disorder caused by damage to the facial nerve, the nerve that supplies the muscles of the face. This damage causes partial or total paralysis of one side of the face.


No one is certain why Bell's palsy occurs, but it may be due to a virus such as herpes simplex, the "cold sore" virus. About 1 of 70 people develop Bell's palsy, usually just once.

Symptoms

Symptoms come on suddenly, sometimes preceded by a day or two of pain behind the ear. About half of all people who get Bell's palsy have partial or full paralysis of the face within 48 hours; the rest develop it within five days. Bell’s palsy symptoms include:Bell's palsy, also called facial palsy


drooping of one corner of the mouth

flattening of the creases and folds in the skin

inability to close one eyelid

a sagging lower eyelid, letting tears spill onto the cheek

heaviness or numbness on the affected side

The paralysis can cause food to collect between the teeth and lips, and saliva may dribble from the corner of the mouth. Some people with Bell's palsy become painfully sensitive to loud sounds

Causes

The exact cause is unknown. Experts think it's caused by swelling and inflammation of the nerve that controls the muscles on one side of the face. It could be caused by a reaction that occurs after a viral infection. Symptoms usually start to improve within a few weeks, with complete recovery in about six months.

Bell's Palsy is a neurological condition in which the seventh facial nerve is not working properly, causing paralysis of one side of your face. Most people don't know that Bell's Palsy is most often brought on by stress and over use of your brain.

Viruses that have been linked to Bell's palsy include viruses that cause:


Cold sores and genital herpes (herpes simplex)

Chickenpox and shingles (herpes zoster)

Infectious mononucleosis (Epstein-Barr)

Cytomegalovirus infections

Respiratory illnesses (adenovirus)

German measles (rubella)

Mumps (mumps virus)

Flu (influenza B)

Hand-foot-and-mouth disease (coxsackievirus)

Risk factors

Bell's palsy occurs more often in people who:


Are pregnant, especially during the third trimester, or who are in the first week after giving birth

Have an upper respiratory infection, such as the flu or a cold

Have diabetes

Have high blood pressure

Have obesity

Recurrent attacks of Bell's palsy are rare. But when they do recur, there's often a family history of recurrent attacks. This suggests that Bell's palsy might have something to do with your genes.

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Complications

A mild case of Bell's palsy typically disappears within a month. Recovery from a more severe case where the face was completely paralyzed can vary. Complications may include:


Irreversible damage to your facial nerve.

Irregular regrowth of nerve fibers. This may result in involuntary contraction of certain muscles when you're trying to move other muscles (synkinesis). For example, when you smile, the eye on the affected side may close.

Partial or complete blindness of the eye that won't close. This is caused by excessive dryness and scratching of the clear protective covering of the eye (cornea).

Prevention

You cannot prevent Bell's palsy

Because it's probably caused by an infection, Bell's palsy cannot usually be prevented. It may be linked to the herpes virus. You'll usually only get Bell's palsy once, but it can sometimes come back. This is more likely if you have a family history of the condition.