Bell Palsy

by Michael_Koger

Bell palsy is a common disorder of the facial nerve, and its cause is still a mystery.

In the 19th century, a Scottish physician, Sir Charles Bell, described the anatomy of the seventh cranial nerve. The occurrence of a “droop” on one side of the face has gained attention from neurologists and other medical doctors over the decades, and the name of the condition is, of course, in honor of Bell [1, 2].

The seventh cranial nerve is the same as the facial nerve, and it has many roles for humans. For example, it controls facial expression, taste, tear production from the eyes, salivation, and sensation of the ears. This important nerve also participates in smiling, frowning, and blinking of the eyes. Hence, it is a mixed sensory and motor nerve, and whenever damage to it takes place, the consequences can be somewhat devastating for the patient [1, 2].

The Facial Nerve

The facial nerve travels from the brainstem and enters the internal acoustic meatus.  Then it continues through the facial canal as it follows the longest bony course of all 12 cranial nerves [2].

In cases of Bell palsy, there is damage to this nerve, and injury to the face or skull may contribute to this situation [2]. 

The medical condition is a rather benign one which resolves on its own in most cases within a few weeks.  However, there are social and psychological issues as many of these clients are quite concerned about the uneven appearance or “sag” which family members and friends will likely notice [1, 2].

It can happen at any age but is most common in those between the ages of 16 and 60 [2].  There does not seem to be any gender predisposition.  Moreover, there is no racial/ethnic disparity.  The number of new cases in the United States each year is 20 per 100,000 population.

Connection with other Illnesses

There are several other conditions, however, which can create susceptibility for Bell palsy.  Some of these include diabetes mellitus, obesity, and hypertension.  Though pregnancy is not usually a disease, it may place the woman at risk for paralysis of the facial nerve [1, 2].

Tumors, sarcoidosis, Lyme disease, and chronic middle ear infection may also predispose to the occurrence of Bell palsy [1].

Some scientists believe that this infirmity is the result of inflammation of the seventh cranial nerve, and this leads to swelling and inadequate blood flow.  There may be loss of myelin sheath which covers the nerve.  Others contend that it is the result of herpes simplex virus I infection [1, 2].

Nevertheless, there are a variety of serious illnesses which may resemble or co-exist with it.  These include stroke, meningitis, multiple sclerosis, and certain autoimmune disorders.  Because of the overlap with these other infirmities, the recommendation is that the patient visit a health care facility whenever there is question about his or her own health [1, 2].

In fact, the use of corticosteroids such as prednisone will likely lessen the course of this illness especially when the patient visits a doctor within three days of the onset of clinical signs or symptoms [1, 2].

Conclusion

Bell palsy is a well-known, though benign, medical condition which tends to resolve without any medical treatment or evaluation.  However, the presence of clinical signs and symptoms which resemble it mandate an evaluation in order to ensure there are no other serious medical conditions present.

References

  1. Patel, D. and Levin, K.  (2015).  Bell palsy:  Clinical examination and management.  Cleveland Clinic Journal of Medicine, 82, 419-426.
  2. National Institute of Neurological Disorders and Stroke.  (2003).  Bell’s Palsy Fact Sheet.  Retrieved March 26, 2016.
  3. The photo is of a library at the United States Centers for Disease Control and is reprinted with permission from that organization.

Disclaimer

The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact their physician for advice.

Updated: 04/01/2016, Michael_Koger
 
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