Bell’s Palsy: What is Bell’s Palsy, Causes, Symptoms, Treatment
What is Bell’s Palsy?
Bell’s palsy is defined as an idiopathic paresis or paralysis of the facial nerve of sudden onset.
- Cold exposure
- Infections of the nasopharynx and facial space
- Inflammatory change in nasopharynx and facial spaces
- Involvement of the nerve at the stylomastoid foramen
- Intra cranial cause-
- Extra cranial cause-
1. Age: 20-50 years.
2. Sex: Female predilection.
3. Pain precedes facial palsy.
4. There is sudden onset. Usually patient gives history of occurrence after awaking early in the morning.
5. Unilateral involvement of the entire side of the face is seen.
6. The corner of the mouth drops, causing drooling of saliva.
7. In an attempt to close the eyelid, the eyeball rolls upward so that the pupil is covered and only the white sclera is visible. This is called the Bell’s sign.
8. Inability to wrinkle the forehead or elevate the upper or lower lip.
9. The eye waters due to inability to close.
10. There is obliteration of the Nasolabial fold.
11. Whistling is impossible.
1. It is cured spontaneously in 90% cases.
2. In 10% cases it does not cure spontaneously. Then treatment is needed.
3. If incomplete paralysis is seen in electromyography, then prognosis is good.
4. At first steroid is given for anti-inflammatory effect e.g. Prednisolone 20 mg 4 times daily for 5-10days. Then the dose will be tapered off in the next 4 days.
5. Acyclovir for anti viral effect.
6. When incomplete eye closure is present, artificial lubrication is indicated.
7. Physiotherapy is indicated.
8. Facial nerve decompression.
9. Intra oral prosthesis.
10. Cosmetic surgery of mouth in case of drooping.