Bell’s Palsy

Bell’s Palsy is a medical condition that hits close to home for me because my step dad has recurrent bouts, which seems especially sporadic at times and he usually wakes up with one side of his face paralyzed, for no apparent reason. Its happened twice since I’ve known him. Although it usually goes away, it can be irritating to the person experiencing the Bell’s Palsy, other than vanity reasons, since they can have sensory as well as motor inability.

The reason I write this post is because today, one of the teachers at my school, had a similar presentation: one half of his face was paralyzed, yet he still had sensation to it. So he just had loss of all motor function (typical to the presentation in the picture and to normal Bell’s Palsy cases). However his was not Bell’s Palsy, but a cystic tumor growing on the inside of his temporal bone, which was compressing the facial nerve (cranial nerve VII – the same in Bell’s Palsy), and causing the apparent paralysis. The only way that this was identified was through an MRI, many weeks later.

Bell’s Palsy typically presents with unilateral facial paralysis (usually on the affected side that the nerve is irritated), and can even experience loss of taste in the anterior (front) 2/3 of the tongue. The person will also have loss of their ability to blink their eye, which can result in a dry eye (normally eyelids help to spread fluid over the eye to keep it moist). Subsequent uncontrollable tearing may also result.The corner of the mouth on the affected side will droop down, unable to be lifted until regeneration of the nerve axons can be established (at times this does not happen, resulting in permanent loss). Another interesting characteristic is an increase or decrease in audible sounds on the affected side, due to a branch of the facial nerve traveling to the stapedius (inner ear bone), which is involved in amplification and transmittance of sound waves.

For those of you more interested in the anatomy of the nerve, please look at this diagram:

This condition typically goes away on its own, or the healing process can be sped up with administration of corticosteroids, typically. Usually patients that have presentation of Bell’s Palsy will be sent for a CT/MRI in order to determine that there is no tumor (as in my teacher’s case) present that is affecting the seventh cranial nerve, the Facial Nerve.

Some predisposing factors could be: idiopathic (no origin), Herpes virus infection, family history, previous attack, or diabetes. A person at any age can be affected, but typically ranges from 15-45 years old. Treatment: only time.

If you or anyone you know has these symptoms, bring them to your primary care physician as soon as possible. You do not want to wait on your own, for in the case of my teacher, it may turn out to be something else. Better safe than sorry!

References:

http://www.mdconsult.com/das/pdxmd/body/266480076-3/0?type=med&eid=9-u1.0-_1_mt_1014441