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Bell’s palsy (facial paralysis) is due to peripheral involvement of the seventh cranial nerve -travels through a narrow, bony canal (called the Fallopian canal) in the skull, beneath the ear, to the muscles on each side of the face. For most of its journey, the nerve is encased in this bony shell.

Disruption in the seventh cranial nerve then,  Bell ‘S palsy occur.

For most people, Bell’s palsy is a temporary problem (occurring for a while). The symptoms begin to improve within a few weeks. It takes about 6 months for the patient to fully recover. In very few people the symptoms of Bell’s palsy develop for a lifetime. In very rare cases, Bell’s palsy is recurrent to a person.

According to a research study :
It is estimated that between 25 and 35 in 100,000 people in the United States are affected by Bell’s palsy. Approximately 40,000 individuals are diagnosed with Bell’s palsy in the United States each year.

In India according to statistics from 66.4% of population, the rate of suffering by diseases is 104.39, and people’s death rate due to Bell’s Palsy is about 9.94%.

Causes of Bell ‘S palsy :

Although the exact cause of Bell ‘S palsy is still unknown, according to Researchers, inflammation in the nerves is most likely triggered by the infection of the viruses.

virus infection :

One type of facial paralysis, also known as Ramsay-Hunt Syndrome, is caused by some virus-like,

Cytomegalovirus infection

Mumps (mumps virus)

Flu (influenza B)

Respiratory disease (adenovirus)

Chickenpox and shingles (herpes zoster)

Hand and foot disease (coxsackievirus)

Mononucleosis (Epstein Barr Virus)

Cold source and genital herpes (herpes simplex virus) etc…

•Lyme disease :
Lyme disease is also one of the reasons for facial paralysis, but because of this, it is a very rare case.

Diabetes :
People with diabetes are more likely to have facial paralysis.

Sign and symptoms of Bell ‘S palsy :

Symptoms of Bell’s palsy may develop suddenly, which  include:

 Saliva dripping from the mouth,

pain around the jaw of the affected side of the face or behind the ear,

• Increased sensitivity to sound in the ear of the affected side,

 •Headache,

 •Decreased ability to feel the taste,

•complete paralysis with a slight weakness in the muscles on one side of the face – this can happen within a few hours to days.

 •Hanging face makes it difficult to make some expressions of the face such as closing eyes or smiling.

 In some very rare cases, Bell’s palsy can affect the nerves on either side of the face.

Diagnosis of Bell’s palsy :

No specific test is available to test Bell’s palsy.  But, some tests are useful to detect Bell’s palsy.

Some conditions like strokes, infections, Lyme disease, and tumors, etc. can also cause weakness in the facial muscles, and symptoms to appear as soon as Bell’s Palsy.

If you are not clear why you are having these symptoms, then the doctor recommends the following test:

Electromyography (EMG) :

EMG confirms the damage to the Nerve and determines how seriously it has been damaged. The EMG test measures the nature and speed of conducting electrical impulses along with muscle Activity.

Sometimes imaging tests like MRI, CT scan, etc. may be needed to detect other possible sources of pressure on the nerves of the face such as tumors and scalp fractures.

Treatment of Bell’s palsy:

Most people suffering from Bell’s palsy are completely cured without treatment. There is no specific treatment for Bell’s Palsy, but your doctor may suggest other medicines and therapy help you recover quickly. In very rare cases of Bell’s palsy, surgery may be required.

The following are commonly used drugs for treating Bell’s palsy:

Corticosteroids :
Corticosteroids are powerful anti-inflammatory drugs like prednisone. these medicines reduce the inflammation of the facial nerve, and these exit nerve fit comfortably into the corridor of the bone. Corticosteroid drugs work even better if they are started within a few days of the onset of symptoms.

Antiviral drugs :
The role of antiviral drugs for Bell’s palsy is uncertain. Antiviral drugs alone showed a placebo effect. no Antivirals mixed with steroids are also unlikely to benefit.

However, in some severe cases of Bell’s palsy, Valacyclovir is given in combination with prednisone.

Physical Therapy:

Due to paralysis of the paralyzed muscles, the muscles may fall short due to contraction. Physical therapists can teach you to properly massage and exercise facial muscles to prevent such a condition from developing.

Surgery:

In some time ago, decompression surgery was used. Under this surgical procedure, the hole in the bone was opened through which the facial nerves pass through. Nowadays decompression surgery is not recommended, as this surgery procedure involves the risk of permanent facial nerve damage and loss of hearing.

In rare cases, plastic surgery is needed to permanently cure facial nerve problems.



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