Bell’s palsy is a common condition that results from the paralysis of the facial nerve. This condition is quite common.  It usually affects one side of the face in the forehead and lower facial areas.  Several physical manifestations of Bell’s palsy include difficulty closing one eye, slurred speech, drooping of one corner of the mouth, inability to whistle, drooling when drinking, or a wrinkle-free forehead on one side.

Bell’s palsy can occur very rapidly. Men and women are affected equally.  Most cases occur between the ages of twenty and forty.  It usually takes close to three weeks for it to reach its maximum effect.  From the maximum effect, most cases recover within three weeks.  Severe cases can take up to six months to resolve completely.  Typically, recovery results in very few if any permanent manifestations.   The longer the recovery however, the more likely the risk of incomplete recovery.  Patients over the age of sixty are at a greater risk of being left with long term effects of Bell’s palsy.

What causes Bell’s palsy?  That is difficult to answer.  Several conditions can be linked to Bell’s palsy such as herpes simplex infections, bacterial infections, shingles, Lyme disease, upper respiratory tract infections, fever, dental surgery, exposure to extreme cold, or menstruation.

Blinking is required to spread fresh tears across the eye and to reduce the evaporation of tears into the atmosphere.  Since patients affected by Bell’s palsy cannot blink one eye, the cornea (clear cover of the eye) becomes dry resulting in ocular discomfort. The lack of tears covering the cornea can lead to corneal scarring and eventually severe vision loss in the worst cases.

Treating the ocular effects of Bell’s palsy requires frequent use of artificial tears drops during the day and artificial tear ointments at bedtime to keep the cornea moist.  Some patients need to wear an eye patch or tape their lids shut while sleeping for added relief.  In more severe cases of dry eye due to Bell’s palsy, there are a couple of surgical options available.  The first one involves implanting a tiny gold weight into the upper lid to pull the lid down.  The second option is called a partial tarsorrhaphy.  This involves the upper and lower lids to become partially sutured together to reduce corneal exposure.  There is some debate in the medical community regarding the role of oral antiviral and corticosteroid medications in treating Bell’s palsy.

Bell’s palsy can be a very frustrating and painful condition to endure.  For those where recovery is not complete the change in the appearance of one’s facial features can be a dramatic change. Fortunately, most recover completely with no increased chance of reoccurrence.

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