Bell's Palsy
Bell’s Palsy is a condition where there is inflammation of the nerve responsible for moving the muscles of face, the 7th cranial nerve, called the facial nerve, causing one-sided weakness or paralysis (a palsy). The mouth droops, there is inability to smile or grin (the lips are drawn to the normal side, making a snarl), and it may be impossible to close the eye. There are problems with eating and speaking, and saliva may drool down the chin. So-called 7th nerve palsy may occur in association with other diseases such as meningitis, brain tumours or diabetes mellitus, but many cases of Bell's Palsy arise out of the blue. They are often preceded by pain underneath the ear, which is where the facial nerve leaves the skull. Rarely there may be associated infection by the shingles virus, herpes zoster, affecting the ear canal - called the Ramsay Hunt Syndrome. The general rule is that Bell's Palsy will recover, and will do so more quickly if it’s only the outer lining of the nerve, the myelin, that's affected. If the inner part, the axon, has degenerated then recovery usually takes longer. The use of steroids, if started early in the course of the illness, are thought by many to make recovery faster, and in the case of herpes zoster infection the use of anti-viral medicine may also be effective (in fact some practitioners will recommend the use of anti-viral medication in all cases of Bell's Palsy, feeling that there is a viral aetiology which may respond to the treatment). During the course of the illness it may be necessary to stick the eyelids together at night to prevent drying of the cornea and subsequent ulceration. In persistent cases surgery may be required for cosmetic reasons. Another cause of facial paralysis is stroke (see the brain in the head section): in this case, however, it is still possible to wrinkle the forehead, while with Bell's Palsy you can't.
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