Māuiuitanga a Bell Bell's palsy
Bell's palsy is a temporary weakness of the face due to damage to a nerve that controls the facial muscles. It usually happens to one side of the face. Unlike a stroke, the facial weakness of Bell's palsy develops slowly, over hours or days.
Causes of Bell's palsy
Anyone can develop Bell's palsy. It mostly happens between the ages of 15 and 60 years.
The cause of Bell's palsy is not always known, but it is sometimes caused by:
- a virus such as varicella-zoster (that causes shingles)
- an ear infection
- a trauma such as a head injury.
Symptoms of Bell's palsy
Symptoms of Bell's palsy usually develop slowly over hours or days and include:
- your face drooping on one side
- facial pain around your ear on the affected side
- only one side of your face moving when you smile, you may also not be able to frown and speaking clearly may be difficult
- difficulty closing your eye — it may not fully close and may water or become dry
- difficulty when chewing food on the affected side — you may dribble slightly, and food may become trapped between your gum and cheek
- some difficulty with speech, as the muscles in the side of your face normally help with forming some words, for example, words beginning with P
- altered or loss of taste on one side of your tongue
- sensitivity to noise — noises may sound louder than usual, which can be uncomfortable.
If you have symptoms of Bell's palsy, see your healthcare provider urgently as treatment is most useful if started early.
Treating Bell's palsy
You may need a course of prednisone tablets. Prednisone is a steroid medicine that may:
- help to reduce inflammation
- decrease the likelihood of your nerves being damaged.
The treatment is most effective if started within 3 days.
If your Bell's palsy is caused by shingles (a viral infection), your healthcare provider may prescribe a course of antiviral medication such as aciclovir or valaciclovir. If your Bell’s palsy is not due to shingles, antiviral medication is unlikely to be helpful.
If your eye is affected, good eye care is very important. If your eye does not close when blinking, your eye can dry up. You should use eye drops or artificial tears to keep your eye moist. Use artificial tear drops during the day and a thicker solution at night. Ask your healthcare provider or pharmacist for advice.
Also, your eye will not have its normal protection from your eyelid closing. It is important to protect your eye and avoid scratching the cornea (the thin, transparent layer covering your eye). You may be advised to wear an eye patch by day and to tape the affected eyelid closed at night. You can use tape such as Micropore for this, which you can buy at a pharmacy.
Wear sunglasses when outdoors or protective glasses where your eye might be exposed to dust or debris. Report any symptoms of eye irritation, pain or changes to vision to your healthcare provider or optometrist.
As your facial muscle may not be functioning fully, food may become lodged around your teeth and gums on the affected side. It is important to clean this area well and remove all debris after eating.
Facial exercises can be useful to tone your face muscles as the movement begins to return. For example:
- gently raise your eyebrows — you can help the movement with your fingers
- wrinkle your nose
- try to flare your nostrils
- lift one corner of your mouth, then the other
- smile without showing your teeth, then smile with showing your teeth
- bring your eyebrows together in a frown.
If you feel the exercises are making your symptoms worse, reduce the number or frequency of the exercises or seek advice.
Long-term effects of Bell's palsy
For 8 out of 10 people, their symptoms start to improve within 6 weeks and they make a full recovery within 6 months. A few people have the weakness for longer and may need further investigation.