Peripheral facial palsy, also known as Bell's facial palsy, is a neurological disorder that occurs when the facial nerve is affected for some reason, leading to symptoms such as difficulty moving the face, lack of expression on one part of the face or just the tingling sensation.
Most of the time, facial paralysis is temporary, arising from an inflammation around the facial nerve causing compression of the nerve and triggering the symptoms, being more common after an infection by the herpes simplex virus and herpes zoster, but also by cytomegalovirus (CMV), Epstein-Barr (EBV), rubella, mumps, or by immune diseases, such as Lyme disease.
So, if you observe paralysis, it is important to see a general practitioner to identify if there is any other problem that needs treatment. In addition, if you experience other symptoms such as disorientation, weakness in other parts of the body, fever or fainting, it is important to go to the doctor immediately.
Main symptoms
The most frequent symptoms of Bell's facial palsy are:
- Crooked mouth, which is more evident when trying to smile; Dry mouth; Lack of expression on one side of the face; Inability to completely close one eye, raise one eyebrow or frown; Pain or tingling in the head or head jaw; Increased sensitivity of sound in one ear.
The diagnosis of facial paralysis is made through the observation of the doctor and, in most cases, it is not necessary to carry out additional tests. However, to make sure that it is only a peripheral facial paralysis, you can use magnetic resonance, electroneuromyography and blood tests, for example, to find the exact diagnosis.
How the treatment is done
Generally, treatment for facial paralysis consists of the administration of corticosteroid medications, such as prednisone, to which an antiviral such as valacyclovir can be added, however, the doctor only recommends it in some cases.
In addition, it is also necessary to do physical therapy and apply lubricating eye drops to prevent dry eye. The use of eye drops or artificial tears is essential to keep the affected eye properly hydrated and to reduce the risk of corneal damage. To sleep, you should apply an ointment prescribed by the doctor and use eye protection, such as a blindfold, for example.
People who experience pain associated with paralysis can also use an analgesic or anti-inflammatory, such as paracetamol or ibuprofen, for example.
How is physiotherapy done
Physiotherapy uses facial exercises to strengthen muscles and improve facial movements and expressions. However, it is important that these exercises are performed several times a day, every day, to enhance the treatment. Therefore, in addition to the sessions with the physiotherapist it is essential to do the exercises at home, and sometimes you can do sessions with a speech therapist as well.
Check out some examples of exercises that can be done for Bell's palsy.
What can cause paralysis
Facial paralysis occurs due to impairment of the nerves in the face that paralyzes facial muscles. Some of the possible causes of paralysis are:
- Sudden change in temperature; Stress; Trauma; Viral infection with herpes simplex, herpes zoster, cytomegalovirus or others; Rarely, it can be a consequence of other diseases.
Thus, paralysis can occur in the path of the facial nerve inside the brain or outside it. When it occurs inside the brain it is a consequence of a stroke and comes with other symptoms and sequelae. When it occurs outside the brain, in the path of the face, it is easier to be treated and, in this case, it is called peripheral facial or Bell's palsy.
