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Bell's palsy (facial palsy) is characterised by facial drooping due to malfunction of the facial nerve (VII cranial nerve), which controls the muscles of the face. Named after Scottish anatomist Charles Bell, who first described it, Bell's palsy is the most common acute mononeuropathy (disease involving only one nerve), and is the most common cause of acute facial nerve paralysis. Bell’s palsy affects about 40,000 people in the United States every year. It affects approximately 1 person in 65 during a lifetime. Until recently its cause was unknown in most cases, but it has now been related to both Lyme disease and Herpes simplex. Palsy is a medical term derived from the word paralysis and meaning paralysis of a body part often accompanied by loss of feeling and uncontrolled body movements such as shaking. ...
The facial nerve is seventh of twelve paired cranial nerves. ...
Cranial nerves are nerves which start directly from the brainstem instead of the spinal cord. ...
A top-down view of skeletal muscle Muscle is a contractile form of tissue. ...
Sir Charles Bell Sir Charles Bell was a Scottish anatomist, surgeon, and physiologist, b. ...
A nerve is an enclosed, cable-like bundle of nerve fibers or axons, which includes the glia that ensheath the axons in myelin. ...
Acute facial nerve paralysis is a common problem that involves the paralysis of any structures innervated by the facial nerve. ...
Adult deer ticks can be carriers of Lyme disease. ...
The Herpes simplex virus infection (common names: herpes, cold sores) is a common, contagious, incurable, and in some cases sexually transmitted disease caused by a double-stranded DNA virus. ...
Symptoms
Additional symptoms that may accompany the condition are pain around the ear and loss of taste. In the great majority of patients, only one side of the face is affected. Detection of sensory loss, hearing loss, or ataxia during examination militates against the diagnosis of Bell's palsy and suggests the need for further evaluation. Ataxia (from Greek ataxiÄ, meaning disorder) is unsteady and clumsy motion of the limbs or trunk due to a failure of the fine coordination of muscle movements. ...
Investigation Clinicians should determine whether all branches of the facial nerve are involved, or whether the forehead muscles are spared. Since these receive innervation from both sides of the brain, the forehead can still be wrinkled by a patient whose facial palsy is caused by a problem in the brain rather than in the facial nerve itself. A nerve is an enclosed, cable-like bundle of nerve fibers or axons, which includes the glia that ensheath the axons in myelin. ...
Diagnosis Bell's palsy is a diagnosis of exclusion, and in many cases no specific cause can be ascertained.
Pathology It is supposed to be the result of inflammation of the facial nerve which produces pressure on the nerve as it exits the skull within its bony canal. Patients with facial palsy for which an underlying cause can be readily found are not generally considered to have Bell's palsy per se. These underlying problems include tumor, meningitis, stroke, diabetes mellitus, head trauma and inflammatory diseases of the cranial nerves (sarcoidosis, brucellosis etc). In these conditions, the neurologic findings are rarely restricted to the facial nerve. Babies can be born with Facial palsy and they exhibit many of the same symptoms as people with Bell's palsy, this is often due to a traumatic birth which causes irrepairable damage to the facial nerve, i.e.acute facial nerve paralysis. Inflammation is the first response of the immune system to infection or irritation and may be referred to as the innate cascade. ...
See the article about cancer for the main article about malignant tumors. ...
Inferior view of a brain with meningitis caused by Haemophilus influenzae. ...
A stroke or cerebrovascular accident (CVA) occurs when the blood supply to a part of the brain is suddenly interrupted by occlusion (an ischemic stroke- approximately 90%of strokes) or by hemorrhage (a hemorrhagic stroke - approximately 10% of strokes). ...
Diabetes mellitus is a medical disorder characterized by varying or persistent hyperglycemia (elevated blood sugar levels), especially after eating. ...
In medicine, a trauma patient has suffered serious and life-threatening physical injury resulting in secondary complications such as shock, respiratory failure and death. ...
Acute facial nerve paralysis is a common problem that involves the paralysis of any structures innervated by the facial nerve. ...
One disease which may be difficult to exclude in the differential diagnosis is involvement of the facial nerve in infections with the herpes zoster virus. The major differences in this condition are the presence of small blisters, or vesicles, of the external ear and hearing disturbances, but these findings may occasionally be lacking. Herpes zoster, colloquially known as shingles, is the reactivation of varicella zoster virus, leading to a crop of painful blisters over the area of a dermatome. ...
In recent years two new suspects have been added to the possible causes of Bell's palsy. Lyme disease may produce the typical palsy, and may be easily diagnosed by looking for Lyme-specific antibodies in the blood. In endemic areas Lyme disease may be the most common cause of facial palsy. The subsequent observation of an increased incidence of antibodies to the Herpes simplex virus in patients with Bell's palsy has led many specialists to believe that this agent is the most likely underlying cause in areas where Lyme disease is uncommon. Adult deer ticks can be carriers of Lyme disease. ...
Wikipedia does not yet have an article with this exact name. ...
The Herpes simplex virus infection (common names: herpes, cold sores) is a common, contagious, incurable, and in some cases sexually transmitted disease caused by a double-stranded DNA virus. ...
Epidemiology It is three times more likely to strike pregnant women than non-pregnant women [1].
Treatment Treatment is a matter of controversy. In patients presenting with incomplete facial palsy, treatment may be unnecessary. However, patients presenting with complete paralysis, marked by an inability to close the eyes and mouth on the involved side, are usually treated with anti-inflammatory corticosteroids. The efficacy of this treatment has not been reliably demonstrated. The likely association of Bell's palsy with the herpes virus has led most American neurologists to prescribe a course of anti-viral medication (such as acyclovir) to all patients with unexplained such facial palsy. Surgical procedures to decompress the facial nerve have been attempted, but have not been proven beneficial. Paralysis is the complete loss of muscle function for one or more muscle groups. ...
In physiology, corticosteroids are a class of steroid hormones that are produced in the adrenal cortex. ...
Aciclovir (INN) or aciclovir (USAN), marketed as Zovirax®, is one of the main antiviral drugs. ...
Surgery Surgery is the medical specialty that treats diseases or injuries by operative manual and instrumental treatment. ...
Although most patients (60–80%) recover completely from Bell's palsy within several weeks, some require several months, and others may be left with deficits of varying degrees.
Complications Major complications of the condition are chronic loss of taste, chronic facial spasm and corneal infections. To prevent the latter, the eyes may be protected by covers, and tear-like eye drops or eye ointments may be recommended, especially for cases with complete paralysis. Where the eye does not close completely the reflex is also affected and great care should be taken to protect the eye from injury. A spasm is a sudden, involuntary contraction of a muscle, a group of muscles, or a hollow organ, or a similarly sudden contraction of an orifice. ...
Paralysis is the complete loss of muscle function for one or more muscle groups. ...
In addition, around 6% of patients exhibit crocodile tear syndrome on recovery, where they will shed tears while eating. This is thought to be due to a faulty regeneration of the facial nerve as it runs to the lacrimal and salivary glands. Tears trickling down the cheeks Lacrimation is the bodys process of producing tears, which are a liquid to clean and lubricate the eyes. ...
Famous sufferers Well-known patients with Bell's palsy include Canada's 20th Prime Minister Jean Chrétien, WWE commentator Jim Ross, and actors Alexis Denisof, Jamey Sheridan and Sylvester Stallone. The Prime Minister of Canada, the head of the Canadian government, is usually the leader of the political party with the most seats in the Canadian House of Commons. ...
The Right Honourable Joseph Jacques Jean Chrétien, PC , LL.D (born January 11, 1934) was the twentieth Prime Minister of Canada, serving from November 4, 1993, to December 12, 2003. ...
World Wrestling Entertainment, or WWE, is a professional wrestling promotion, currently the largest in North America. ...
Jim Ross James W. (Jim) Ross, also known as J.R., or Good Ol J.R. (born January 3, 1952 in Westville, Oklahoma), is a professional wrestling play-by-play announcer working for World Wrestling Entertainment on the RAW brand. ...
Alexis Denisof (born February 25, 1966) is an American actor best known for playing Wesley Wyndam-Pryce in the television series Buffy the Vampire Slayer and its spin-off Angel. ...
Jamey Sheridan (born July 12 1951 Pasadena, California) is an American actor. ...
Sylvester Stallone Sylvester Gardenzio Stallone (born July 6, 1946 in New York City), usually known as Sylvester Stallone, is an American film actor, director, producer, and screenwriter. ...
References The Merck Manual of Diagnosis and Therapy (often referred to simply as The Merck Manual) is one of the worlds most widely used medical textbooks. ...
The New England Journal of Medicine (NEJM) is a peer-reviewed medical journal published by the Massachusetts Medical Society. ...
External Links - Bell's Palsy Information Site, has a FAQ
- Bell's Palsy and Pregnancy
- Neurology Channel
- Living with Facial Palsy, a site for parents of children with Facial Palsy
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