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Bell ’s palsy resolves on its own in 70 - 75 % of patients without any treatment.(1 )
Bell ’s paralysis is three times more common in pregnant cleaning lady than the universal population.(2 )
How To Stop Bell’s Palsy From Spreading?
To stop Bell ’s palsy from propagate it is all-important to diagnose the condition timely at the initial stage and start the management as early as potential .
To touch the correct diagnosing it is significant to differentiate Bell ’s palsy from another facial paralysis , which mandate elaborate history and strong-arm examination . The differential diagnoses include trauma to the facial nerve , Melkersson - Rosenthal syndrome , Ramsay - Hunt syndrome , stroke , CNS tumor , HIV infection , Lyme disease , Guillain - Barre syndrome , multiple sclerosis , otitis medium , sarcoidosis , autoimmune diseases ( Sjogren ’s disease ) , cholesteatoma , and metabolic diseases ( diabetes mellitus ) . Bell ’s paralysis is diagnosed when all these causes are excluded(2 ) .
Bell ’s phenomenon ( the up movement of the eye due to weakness of the center brawniness , orbicularis oculi , when trying to exit the eyelid ) is a pathognomonic signal of Bell ’s palsy(2 ) .
commonly , the prognosis of Bell ’s palsy is good as 70 - 75 % of the patients recover fully without the need for treatment . However , the complete retrieval rate increase to 82 % with early intervention with prednisolone ( within 72 time of day of the onset of symptoms)(1 ) .
Since there is no established case of Bell ’s paralysis , the management of it revolves around the reduction of inflammation of facial spunk ; therefore , adrenal cortical steroid for their anti - inflammatory core have been successfully used to assuage the symptom . Prelone at a dose 50 - 60 magnesium / solar day for 10 day to a maximum of 80 mg is used effectively and safely in adult . In diabetic , more than 120 mg / daytime dose has been used safely(1 ) .
Since reactivation of herpes contagion is call for as one of the causes of Bell ’s palsy , antiviral drug ( aciclovir at a dosage of 400 atomic number 12 five times daily for 5 days and valaciclovir 1000 mg / 24-hour interval for 5 days ) have been used either alone or in combining with adrenal cortical steroid , but no extra benefit of antiviral drugs either alone or in combination therapy has been take down in systemic reviews . Therefore , further studies are guarantee to find the efficacy of antiviral drugs in the management of Bell ’s palsy(1 ) .
The inability to shut the eyelids in Bell ’s palsy poses a risk of long - term corneal complication ; therefore , it is important to protect the eye with an centre patch and software of eye lubricants on an hourly basis and eye ointment at night to prevent drying of the cornea(1 ) , ( 2 ) .
Patients start recovering within 3 weeks and sometimes full recovery takes up to 9 months . A delay in diagnosis and management of the disease with medications may lead to residuary disease , which warrant timely management(2 ) .
How Does Bell’s Palsy Present Itself?
Bell ’s palsy is the impuissance or paralysis of the lower motor neuron of the facial nerve . Since the crusade of Bell ’s palsy is still unknown and it impact the seventh cranial brass ( CN VII ) , the facial nerve , is also known as idiopathic facial paralysis . The reactivation of herpes virus virus ( herpes simplex virus and herpes zoster virus ) is debate the most potential cause of the disease . Other potential causes admit excitement , vasculature , infections , and autoimmune disorders(1 ) .
Bell ’s paralysis is seen in individuals between 15 - 50 age group with equal gender predilection . Although it is three times more vulgar in pregnant womanhood ( in their third trimester and early postpartum period ) it can also be seen in patient with diabetes and hypothyroidism , and elderly individuals(2 ) .
The presenting signs and symptoms of Bell ’s palsy may range from mild to severe . The onset of Bell ’s paralysis is keen and unilateral and usually starts within a few hours . Up to 60 % of the patients have a viral infective history . It depart with partial facial failing / palsy , which then lead and leads to complete facial weakness / paralysis within 2 days(2 ) .
The signs show ipsilateral loss of forehead crease , drooping of eyelids , dry heart / or excessive lacrimation , loss of ability to exit the eye completely , swag of the recession of the mouth , going of taste sensation , dribbling of the spittle , hurting around the ear , and hyperacusis ( increase sensitivity to sound)(1 ) .
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