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Bell's Palsy

  • This is a type of facial paralysis, occurring suddenly on one side of the face.  It is thought to be caused by an inflammation of the facial nerve (cranial nerve VII).  60% of afflicted patients get better without treatment, while 90% of those receiving treatment show improvement.  Since a Stroke may have a similar appearance, it is important to make sure that Bell's palsy is truly the cause.  Rare tumors can also cause similar symptoms, and these need to be excluded as well.

  • Ear pain may precede the attack
  • Face feels stiff
  • Difficulty closing the eyelids
  • Difficulty eating and smiling
  • Loss of taste on one side of the tongue
  • Hypersensitivity to noises
  • Bell's palsy often follows an upper respiratory infection.
  • Excessive eye tearing or lack of tearing on one side.

  • Unknown
  • Exposure to a virus or cold may be the cause in some cases.
  • Facial nerve injury due to head trauma, tumors,Herpes Zoster, or Herpes Simplex vesicles in the outer ear canal (Ramsay-Hunt syndrome) can also lead to paralysis of facial nerve.
  • Bilateral facial paralysis occurs very rarely, and is often due to neurological disease such as Guillain-Barre syndrome.

  • Examination
  1. Paralysis of one side of the face
  2. One of the sides of the face appears drooped
  • Imaging
- CT scan or MRI may be done to rule out Stroke.

  • No treatment is an option, especially if the paralysis is mild.
  • Eye patch is helpful if the eye cannot close completely.
  • Corticosteroids, e.g., Prednisone
  • Corticosteroids work best if they are started sooner than later.
  • Lubricating eye drops, if the eyelid remains open.
  • Recent studies show that Acyclovir (an anti-viral medication) may be helpful.

  • Stroke
  • Transient Ischemic Attack


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