Mr Nigam ENT Treatments - Bells Palsy
The cause of Bell's palsy is unknown. It is suspected that an irritated facial nerve becomes swollen due to inflammation. As the facial nerve passes through narrow openings in the skull, it is compressed and symptoms result.
Doctors believe a herpes virus may cause the nerve to become inflamed. Head injuries or facial injuries, tumours, other medical problems, or exposure to cold may also cause Bell's palsy.
In addition, the following factors may increase your chances of getting Bell's palsy:
- Family members who have Bell's palsy
- Pregnancy
- Diabetes mellitus
- Cold or flu
- Weakened immune system
Symptoms
Bell's palsy symptoms may come on suddenly or develop over a few days. Initial symptoms may include:
- Pain behind the ear that precedes the weakness and paralysis
- Ringing sound in the ears (tinnitus)
- Slight fever
- Slight hearing impairment
Symptoms of full-blown Bell's palsy may include:
- Facial weakness or paralysis, preceded by numbness
- Usually one side
- Forehead is smooth
- Not able to smile and difficulty speaking
- Drooping corner of the mouth
- Drooling
- Tearing or decreased tearing
- Inability to close an eye, which can lead to dehydration of the eye, ulcers on the cornea, infection and possible loss of the eye
- Impaired taste
- Sound sensitivity in one ear and earache
- Difficulty speaking
Early diagnosis is critical for receiving an accurate prognosis for recovery and an effective management plan. If you develop symptoms of Bell's palsy, see a specialist as soon as possible after the onset, preferably within five to 10 days.
Investigations
In most instances no investigations are required but may include:
- Hearing test, to see if nerve damage involves the hearing nerve, inner ear, or hearing mechanism
- Balance test, to see if balance nerves are involved
- Tear test, to measure the eye's ability to produce tears
- Computed tomography (CT) scan or magnetic resonance imaging (MRI) scan, to see if there is an infection, tumour, bone fracture, or other problem in the area of the facial nerve
- Electrical test, to determine the extent of damage to the facial nerve
- Blood tests, to check for diabetes, HIV infection, or Lyme disease
Treatment
If presenting early there is usually a good response to a short course of oral steroids in patients where there is no contraindication.
Prognosis
In the vast majority of patients recovery is complete.