Thursday, 8 August 2013

BELL'S PALSY



This disorder was named after Scottish Anatomist Charles Bell who first described it.

Bell’s palsy is a kind of facial paralysis that results from a malfunction or damage of the facial nerve (cranial nerve VII). This causes an inability to control the facial muscles on the affected side and most times the affected part of the face droops. This condition happens suddenly, often overnight, and usually gets corrected on its own within a few weeks or months.

This facial weakness associated with Bell’s palsy could be partial (mild muscle weakness) or complete (paralysis, although this type is very rare). It is the most common acute mono-neuropathy, i.e. a disorder involving just one nerve.

Bell’s palsy is believed to be caused as a result of the inflammation of the facial nerve. The exact cause of this inflammation is not specifically known. But it is possible due to infections from viruses of the Herpes simplex virus family (Varicellar-Zoster virus, and Epstein-Barr virus)

Bell’s palsy is rare. It affects about 1 in 5,000 people in a year. It affects both men and women equally and is commonly found in those aged between 15 and 45. But people outside this age group can also suffer from this condition. For reasons not fully understood, pregnant women and people with HIV and diabetes are more predisposed to this condition.

The major symptoms are

·        - Weakness or paralysis on one side of the face making it difficult to close the eyelid and causing the mouth to droop.
·        - Eye irritation such as increased tear production or dryness. Often the eye in the affected side cannot be closed.
·        - Pain around the ear on the affected side
·        - Increased sound sensitivity
·        - Reduced sense of taste
·        - Impaired speech
·        - Headache
·        - Dryness of the mouth and pain around the jaw

Most people with Bell’s palsy recover complete without treatment within 1-2 months. But there are treatment options to accelerate the recovery process and also reduce the chances of complications. They are:

- Currently, the steroid, Prednisolone, is the most effective drug for Bell’s palsy. It helps reduce inflammation (swelling) of the face and works best if administered within 3days after the onset of symptoms. But prednisolone has side effects such as nausea, headache, increased sweating, hunger, dizziness, and even oral thrush. But the side-effects go away as your body gets used to the medication.

- If a virus is diagnosed to have caused it, antiviral drugs can also be administered. This medication may be offered only if your facial paralysis is severe

- Often, the eye in the affected side cannot be closed, as such it has to lubricated or well protected from drying up if not the cornea may be permanently damaged resulting in impaired vision. Lubricating eye drops should applied frequently during the day while an eye ointment should be used at night

- Facial exercises can also help a great deal. Doing simple exercises like massaging, tightening and relaxing your facial muscles will make them stronger again and help you recover quickly. It will also prevent permanent contractures caused by the shrinking and shortening of the paralyzed muscles


- In rare and severe cases, plastic surgery may be recommended. Though it may not be able to restore nerve function, but it may be able to improve the appearance and symmetry of the face
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