Diagnosis of Bell's Palsy

Bell's palsy is a temporary paralysis of one side of the face. Facial paralysis occurs when nerves that control facial muscles are damaged. The condition appears suddenly and symptoms typically improve in 2 to 3 weeks, with full recovery in 3 to 6 months. Bell's palsy affects approximately 40,000 people a year, according to the Mayo Clinic.

Causes

• Bell's palsy occurs from damage to the seventh cranial nerve, or the facial nerve. The cause of nerve damage has not been found but may be associated with herpes infections. Inflammation or swelling of the nerve causes Bell's palsy symptoms.

Risk Factors

• Your risk of Bell's palsy increases if you are pregnant or have diabetes. Other risk factors include respiratory infections such as a cold or the flu.

Symptoms

• Symptoms typically occur suddenly and can range from mild to severe. Symptoms may include drooling, difficulty drinking or eating, facial drooping, loss of sense of taste, headache, twitching or weakness in the face. Other symptoms may include pain in the ear on the affected side of the face, dry eyes and mouth, droopy eyelid and a sensitivity to sound.

Warnings

• When nerve damage is severe, symptoms may become chronic. Problems with taste, muscle spasms of the eyelid and damage to the eye may occur. Change in the appearance of the face from loss of movement may also be apparent.

Diagnosis

• No specific test can diagnose Bell's palsy. Your doctor will examine your face and may recommend tests to rule out other causes of facial paralysis such as stroke or tumors. An electromyography measures electrical activity in the muscles to see how they respond to stimulation. Magnetic resonance imaging (MRI) or a computed tomography (CT) scan may be ordered to determine whether the paralysis is caused by compression on the nerve from a tumor or infection.

Treatment

• Bell's palsy normally resolves on its own, but your doctor may recommend medications if the disorder is severe or in order to speed up recovery. Corticosteroids may be prescribed if inflammation of the nerve is the cause. Steroids reduce swelling, allowing the nerve to fit better in its bony confines. Antiviral medications such as acyclovir will be prescribed if the nerve has been infected by a virus.
  Physical therapy using massage to exercise facial muscles may help to avoid permanent contractions in the face from muscles that have shortened or shrunk.
  Lubricating eye drops may be recommended for dry eyes and an eye patch worn at night.
  Surgery is rarely indicated for Bell's palsy, as other treatments can normally help with symptoms of the disorder.