THE BLOG

Bell's Palsy: What Is It And Who Does It Affect?

04/10/2017 13:07 BST | Updated 04/10/2017 13:07 BST

What do Pierce Brosnan, Ayrton Senna, and George Clooney all have in common ... other than their fame? They all at one point suffered from Bell's Palsy - and they aren't the only celebrities to have had it!

What is Bell's Palsy?

Bell's Palsy is a condition that causes one side of the face to become weakened or paralysed, resulting in drooping and a loss of expression on the affected half. Fortunately, this condition is temporary for most people and is treatable. However, around 30% of sufferers will experience ongoing, residual facial symptoms.

Your facial expressions are powered by many different muscles, which are all controlled by branches of the facial nerve, there are two of these nerves, each controlling one half of the face. If one of these nerves is damaged in any way, all the muscles that are supplied by it will be either weakened or paralysed completely.

Damage to the facial nerve can be caused by anything from direct trauma to a stroke. In the case of Bell's palsy, it is believed that it may be due to inflammation of the nerve as it passes through a narrow passage in the skull to reach the facial muscles and that this swelling is triggered by a viral infection. However, Bell's Palsy is currently described as an idiopathic disease, meaning a definitive cause is currently unknown.

Signs and Symptoms

Bell's Palsy is usually a painless condition and the symptoms are restricted to one half of the face, which will experience weakness or paralysis.

This results in:

● An inability to make facial expressions - for example, if you try to smile only one half of your mouth will respond

● Difficulty eating and speaking - caused by the weakness of the facial muscles

● Drooling - the weakness of the muscles around the mouth cause it to droop open and prevent it from closing

● Dry eyes - the muscle around the eye that is responsible for shutting it is weakened, impacting the ability to blink or close the eye.

Other symptoms of Bell's palsy reflect the other roles of the facial nerve. One of its branches supplies part of the tongue, so patients with Bell's palsy may experience an altered sensation of taste one side of the tongue. They may also have an increased sensitivity to loud sounds, as one of the muscles controlled by the facial nerve lies in the ear and is involved with hearing. Bell's palsy can also cause an earache and headache. The symptoms of this condition develop gradually over a few days, usually peaking at 48 hours. Patients generally start recovering in a few weeks and, by nine months, 70% will have fully recovered, with or without treatment.

Other Causes of Facial Weakness

If you or anyone you know exhibits the signs of one-sided facial weakness or paralysis, such as facial drooping or slurred speech, it is crucial that you go to A&E immediately or call for an ambulance. This is because it may not be Bell's Palsy but another more serious condition with similar. Generally, other conditions will have additional symptoms, however it is best to consult a medical professional who will be able to conduct a full assessment. Bell's palsy is a diagnosis of exclusion, meaning that it is only diagnosed once all other possible causes have been disregarded.

How to Manage Bell's Palsy

The treatment of Bell's palsy has two aims, to speed up recovery and protect the eyes. Because the eye on the affected side can become dry and irritated. A doctor will prescribe some lubricating eye drops and advise taping your eye closed whilst you sleep. This helps to keep them moist and avoid eye complications.

Patients with Bell's palsy are also prescribed steroids to reduce the nerve swelling and improve symptoms, as steroids have been shown to increase the likelihood of recovery of nerve function. This will take the form of a 10-day course of prednisolone tablets which should be given within the first 72 hours of the symptoms appearing. Steroids are strong drugs which can have many side-effects; if you are concerned about these or are experiencing any side effects make sure to contact your GP. These effects usually subside after a few days as your body becomes adjusted to the medication.

In some cases, where there is evidence of an obvious viral infection, an antiviral medication may also be prescribed; although the evidence is limited.

Complications

While most people with Bell's palsy will make a full recovery after nine months, there are a few that may experience ongoing symptoms. One of the complications of this condition is corneal ulceration, which is caused by chronic irritation of the eye. This can be avoided with good eye care during the recovery period.

Other complications are caused by the incomplete healing of the damage to the facial nerve. 20% of patients with Bell's palsy will go on to experience long-term effects of the condition. This is more likely to occur in patients who experienced complete paralysis on one side, have high blood pressure, diabetes, or are over 60. Residual nerve damage can cause these patients to experience permanent facial weakness, speech problems, facial tightness, and other ongoing symptoms. Some of these complications may be treated with physiotherapy or surgery to improve cosmetic appearance and function, and Botox injections are used to alleviate facial tightness.

Dr Seth Rankin is founder of London Doctors Clinic