Bell's palsy is a weakness of the facial muscles. It develops suddenly, usually on one side of the face. The cause is not clear but most cases are probably due to a viral infection. You should protect your eye if you cannot close your eyelids fully.
First see a doctor to rule out stroke or a TIA (transient ischemic attack). If they then diagnose your facial paralysis as Bell's Palsy, they will probably explain that this is caused by inflammation of the facial nerve, which will often just go away gradually. There appear to be several possible factors involved in Bell's Palsy, and these seem to create different durations -- most people will see their it simply resolve itself in a month or two. A small number, however, have permanent muscle weakness or paralysis. Bell's palsy is named after the doctor who first described it.
You have a facial nerve (also called the seventh cranial nerve) on each side of your face. Each facial nerve comes out from your brain, through a small tunnel in your skull just under your ear.
The nerve splits into many branches that supply the small muscles of the face that you use to smile, frown, etc. It also supplies the muscles that you use to close your eyelids.
Branches of the facial nerve also take taste sensations from your tongue to your brain.
Anyone can get Bell's palsy, and it affects both men and women equally. It most commonly occurs between the ages of 10 and 40. Bell's palsy is the most common cause of a sudden facial weakness. About 1 in 70 people have a Bell's palsy at some stage in their life.
It is thought that inflammation develops around the facial nerve as it passes through the skull from the brain. The inflammation may squash (compress) the nerve as it passes through the skull. The nerve then partly, or fully, stops working until the inflammation goes. If the nerve stops working, the muscles that the nerve supplies also stop working.
The cause of the inflammation is not known but, in most cases, it is probably due to a viral infection. There is some evidence that the cold sore (herpes simplex) virus or the chickenpox virus causes most cases of Bell's palsy. Most people have chickenpox at some stage (usually as a child) and many people have cold sores. The virus does not completely go after you have chickenpox or a cold sore. Some particles of virus remain inactive (dormant) in the nerve roots. They do no harm there, and cause no symptoms. For reasons that are not clear, the virus may begin to multiply again (re-activate). This is often many months or years later. In some cases, the 're-activated' virus is thought to cause inflammation around the facial nerve to cause Bell's palsy.
Weakness of the face which is usually one-sided. The weakness normally develops quickly, over a few hours or so. You may first notice the weakness after getting up in the morning, and so it may appear quite dramatic. It may gradually become worse over several days. The effects of the weakness vary, depending on whether the nerve is partially or fully affected. These include the following:
Most cases are painless or cause just a mild ache. However, some people develop some pain near the ear which can last for a few days. Loud sounds may be uncomfortable and normal noises may sound louder than usual. This is because a tiny muscle in the ear may stop working. You may lose the sense of taste on the side of the tongue that is affected.
Yes, you need to be diagnoised by your doctor. When a doctor sees a patient with a sudden facial muscle weakness, he or she will aim to rule out other causes of the problem before diagnosing Bell's palsy. Most other causes can be ruled out by the absence of other symptoms, and by a doctor's examination. No tests may be needed.
However, some tests are done in some situations. For example, in areas where Lyme disease is common (due to tick bites), then tests to rule out Lyme disease may be done. This is because a facial weakness is, rarely, the first indication of Lyme disease. Other tests may be advised if the diagnosis is not clear-cut.
Yes, we have seen very good results using Scenar with Bell's Palsy: the worst aspects of it, including pain and discomfort, extreme sensitivity to noise, and dry, unblinking eyes, have been relatively fast to resolve. Helping the face to look normal again is also relatively fast, but the underlying paralysis, especially the way the person experiences it inside their face (as opposed to how it looks externally) can be particularly slow to respond in some cases. Patience is a virtue, the results can be good.