Bell's palsy is facial paralysis, normally affecting one side of the face, and can last from a number of weeks to a number of years. It is the most common cause of facial paralysis. Bell's palsy is a diagnosis of exclusion; in many cases, no specific cause can be ascertained. The condition may result in a droopy appearance of your face. Bell's palsy is not as uncommon as is generally believed. Worldwide statistics set the frequency at approximately .02% of the population (with geographical variations). This can be a blow to your self-esteem, but most often Bell's palsy isn't serious. In human terms this is 1 of every 5000 people, and 40,000 Americans every year. The facial nerve (seventh cranial nerve) has 2 components. The larger portion comprises efferent fibers that stimulate the muscles of facial expression. The smaller portion contains taste fibers to the anterior two thirds of the tongue, secretomotor fibers to the lacrimal and salivary glands, and some pain fibers. Viral infections such as herpes, mumps, or HIV, and bacterial infections such as Lyme disease or tuberculosis can cause inflammation and swelling of the facial nerve that causes Bell's palsy.

Bell's palsy is more prevalent than generally believed. Bell's palsy should not cause any other part of the body to become paralyzed, weak or numb. Most people either wake up to find they have Bell's palsy, or have symptoms such as a dry eye or tingling around their lips that progress to classic Bell's palsy during that same day. Occasionally symptoms may take a few days to be recognizable as Bell's palsy. The degree of paralysis should peak within several days of onset - never in longer than 2 weeks (3 weeks maximum for Ramsey Hunt syndrome).

Other symptoms may include:

• pain or discomfort around the jaw and behind the ear
• ringing in one or both ears
• headache
• loss of taste
• hypersensitivity to sound on the affected side
• impaired speech
• dizziness
• difficulty eating or drinking

Bell's palsy occurs when the nerve that controls the facial muscles is swollen, inflamed, or compressed, resulting in facial weakness or paralysis. 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.

The most important factor in treatment is to eliminate the source of the nerve damage. Surgical procedures to decompress the facial nerve have been attempted, but have not been proven beneficial. Facial massage and exercises may help prevent permanent contractures (shrinkage or shortening of muscles) of the paralyzed muscles before recovery takes place. Moist heat applied to the affected side of the face may help reduce pain. Other therapies that may be useful for some individuals include relaxation techniques, acupuncture, electrical stimulation, biofeedback training, and vitamin therapy (including vitamin B12, B6, and zinc), which may help nerve growth. In some cases, a small dose of botulinum toxin can be injected into the upper eyelid. Treatment may involve steroid and anti-viral therapy. Painkillers may also be required. It's important to protect the eye from drying, which may result in infection and ulceration. For others, treatment may include medications such as acyclovir - used to fight viral infections - combined with an anti-inflammatory drug such as the steroid prednisone - used to reduce inflammation and swelling.

Treatment for Bell's Palsy

• Surgical procedures to decompress the facial nerve have been attempted, but have not been proven beneficial.
• Facial massage and exercises may help prevent permanent contractures (shrinkage or shortening of muscles) of the paralyzed muscles before recovery takes place.
• Moist heat applied to the affected side of the face may help reduce pain.
• Other therapies that may be useful for some individuals include relaxation techniques, acupuncture, electrical stimulation, biofeedback training, and vitamin therapy (including vitamin B12, B6, and zinc).
• A small dose of botulinum toxin can be injected into the treatment may involve steroid and anti-viral therapy.
• Painkillers may also be required. It's important to protect the eye from drying, which may result in infection and ulceration.
• Treatment may include medications such as acyclovir used to fight viral infections combined with an anti-inflammatory drug such as the steroid prednisone.