Bell's palsy is an idiopathic (of unknown cause) facial paralysis that occurs on one side of the face. It results from damage to some part of the 7th Cranial Nerve (the facial nerve) that arises in the Pons area of the Brainstem. In Multiple Sclerosis, Bell's palsy-like symptoms are usually caused by a lesion in this area.
Like MS, Bell's palsy is diagnosed by exclusion and there are a number of differential diagnoses including Ramsay Hunt Syndrome, Guillain-Barre syndrome, Myasthenia gravis, Idiopathic autoimmune disease, Mechanical Trauma, Otitis Media, Cholesteatoma, Lyme Disease, Mumps, Tuberculosis, HIV, Sarcoidosis, Cerebrovascular Accidents, MS, Other Neurologic Disorders, Poisoning and Melkersson-Rosenthal Syndrome. If no other cause is found idiopathic Bell's Palsy is diagnosed.
Bell's palsy is mostly benign and self-limiting. No effective treatments have been found although steroids are often prescribed although there use for this condition is controversial. Facial massage is probably the best treatment. Recovery usually takes place without treatment within 3 months and almost certainly with a year.
The only long-term worry with Bell's Palsy is the drying up of the eye due to insufficient production of tears. This can be addressed with a special eye patch or artificial tears.
Reoccurrence may happen with a very small percentage of patients, almost always on the same side of the face that was initially affected. As with MS, there appears to be a slight genetic basis for Bell's Palsy, but unlike MS males seem to be affected as often as females. Bell's Palsy typically affects young adults although it can affect any age group.
The 7th Cranial Nerve serves the muscles of the face, salivary glands, taste sensations in much of the tongue, tear glands and the area around the ear. The hearing and balance organs in the ear are served by the 8th cranial nerve and are not affected in Bell's Palsy.
Bell's Palsy Links
Palsy - Mindy Schwartz