Bells palsy is a form of facial paralysis of acute onset due to the dysfunction of cranial nerve 7- facial nerve. There is an inability to control the facial muscles of the affected side leading to inability to close the eyes, deviation of face angle of mouth, drooping of eyelid, drooling, difficulty to smile and make other facial expression, difficulty to eat and drink twitching of muscles of face etc. Other difficulties include dry eye, dry mouth, headache and earache, intolerance to loud sound and loss of taste in one side of tongue.
Bells palsy can affect any age group, but it is more common in adults especially with systemic illnesses like diabetes. Males and females can be equally affected. A positive family history is seen in 6-8% of patients. It can occur in pregnancy due to retention of fluid. Bells palsy can occur in 3-10 % of patients. Exact cause of bells palsy is not known. Always diagnosis is made by exclusion of EBV, herpes simplex , herpes zoster, Vascular headache, ischaemia due to exposure of cold or emotional stress leading to edema and compression of microcirculation of the nerve, autoimmune diseases hereditary predisposition like narrow facial nerve canal making the nerve easily susceptible to early compressor even with slight edema.
A thorough clinical history, complete otological evaluation. Blood investigation MRI to rule out intracranial pathologies are essential. Nerve extability testes maybe done daily to monitor nerve degeneration. Topodiagonostic tests like schirmer's test, tests to asses sensation, stapedial reflex tests, etc. help to establish the cause and to assess the site of surgical decompression if at all required.
Treatment mainly consists of reassurance relief of earache, care of eyes to prevent damage to cornea due to exposure physiotherapy of facial muscle, to bring back the muscle tone and psychological supports medical management with steroids helps to reduce the edema of the nerve and to shorten the recovery time. Antiviral drugs are given through not found to be much useful.Surgical treatment include the decompression of the nerve to improve the microcirculation under microscopic guidance 85-90% patients recover fully 10-15% recover incompletely. Recovery may take 3 weeks to 1 month. Ascent Hospital is one of the top ent hospitals in india. They provide the best treatments.
In addition to the mentioned treatments, patients with Bell's palsy may benefit from other interventions such as acupuncture and electrical stimulation therapy. Acupuncture has shown promising results in improving facial muscle function and reducing pain associated with Bell's palsy. Electrical stimulation therapy involves the use of low-level electrical currents to stimulate the affected facial muscles, which can help enhance muscle tone and promote nerve regeneration. These alternative treatments can be used in conjunction with traditional medical management to optimize the recovery process. It is important for patients to work closely with their healthcare providers to determine the most appropriate treatment plan for their specific condition.