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 Paralysis of one side of the face 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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