Bell's Paralysis: Causes, Symptoms and Treatment

Jul 20, 2018


Bell paralysis is an inflammation of the facial nerve.The Scotsman, Sir Charles Bell, a member of the Royal Society of London, discovered at the beginning of the 19th century that this inflammation leads to transient temporary paralysis of muscles on one side of the face.


  • Causes of Bell's palsy
  • Symptoms and Diagnosis
  • Treatment of Bell's paralysis
  • Prevention of

Causes of Bell's paralysis

Physiologist C. Bell established the mechanism of the onset of the disease, but the cause of the disease could not be identified so far.The facial nerve is clamped in the convoluted canal of the temporal bone.It is motor, i.e.Controlling facial expressions, chewing, swallowing, blinking, frowning.

It has an intermediate nerve, responsible for the normal functioning of the salivary glands, taste sensitivity of the front 2/3 of the tongue.He can be affected to varying degrees, and therefore Bell's paralysis manifests itself in different ways: from the temporary inexpressiveness of facial expressions to the "withering away" of half of the face.

cause of the disease is called:

  • polio infection and herpes zoster
  • stroke
  • hypothermia
  • meningitis
  • otitis
  • pregnancy
  • chemotherapy
  • mezotimpanit
  • mumps
  • diabetes
  • heredity( narrow neural canal)
  • smoking
  • head or face injury
  • influenza
  • internal bleeding
  • acute respiratory disease
  • multiple sclerosis
  • HIV
  • Lyme disease
  • vertebral artery aneurysm
  • intoxication
  • abscess
  • tumors, incl.Cancer

There are many assumptions, but the exact cause is not established.It is clear only that the conductivity of the nerve impulse from the brain to the mimic muscles is disturbed.

Symptoms and Diagnosis

More often signs of loss of motor function of facial muscles appear in the morning:

  • pain behind the ear and / or in the angle of the jaw,
  • fever Bell symptom - raising the eyeball when trying to close the eye due to paralysisThe circular muscle of the eye and the occipitus and frontal muscle
  • stiffness and / or a feeling of heaviness of the face, it "twists"
  • smoothing of wrinkles on the affected area
  • loss of control over mimic muscles: a man struggles to wrinkle his forehead,Flashes, the expressiveness of the face is lost
  • hanging mouth angle, asymmetry with teeth grin, the patient can not smile and clearly speak
  • symptom of the sail - the patient does not hold the air behind his cheek
  • salivary dysfunction( salivation), in which the saliva is constantly flowing from the half-open mouth
  • partial loss of taste sensations
  • reddening of eyes
  • dry eyes and / or continuous tearing - "crocodile tears";This can lead to the appearance of ulcers on the cornea
  • hearing disorder: increased pain sensitivity to sounds( hyperacusis), hearing loss( hypacusia) or unilateral anacusia - deafness, ringing in the ears
  • Miyyara-Gobler or Fovill syndrome

May not be manifestedAll the symptoms or not at the same time, but gradually.

Diagnosing Bell's paralysis is difficult, because its symptoms are no different from other diseases.The main sign for the doctor is the suddenness of the illness.For the diagnosis is conducted conversation and examination.

In addition, magnetic resonance imaging of the head with contrast is prescribed, computed tomography of the skull, electromyography for examining the conductivity of nerve fiber and checking electrical activity, excitability of muscles.

Electrostimulation is also performed to determine the degree of impairment of the functions of the facial nerve.In addition, the neurologist can prescribe a blood test, serological test, lumbar puncture or chest X-ray to exclude diseases with similar symptoms.

The variety of signs of this paralysis significantly complicates the setting of a true diagnosis.

Absence of treatment can lead to muscle atrophy

Treatment of Bell's paralysis

In most cases, self-healing occurs, but if the disease is protracted, the muscles can atrophy.The lack of treatment can lead to other unpleasant consequences.

Therapeutic methods include conservative and surgical treatment.The conservative way involves taking medication, protecting the eyes, strengthening the facial muscles and physiotherapy.

Drug therapy - receiving patient:

  • hormonal agents: anti-inflammatory corticosteroids( metipred, Nerobolum, Nerobolum) improving metabolism of glucocorticoids( prednisolone)
  • spasmolytics for suppression of muscle spasms
  • decongestants, vasoconstrictors and improving cerebral circulation vasodilator drugs( Dibazol)
  • dehydration remedies for headaches
  • analgesics for the relief of pain syndrome
  • antioxidants and in
  • antiviral drugs( Valaciclovir, Valtrex, Famciclovir, Acyclovir, Zovirax)
  • drops - natural or artificial tears, physiological( isotonic) solution - for moisturizing the cornea
  • special eye ointment( lubricant)

To protect the unprotected eye, it is recommendedWearing glasses and bandages( including wet), especially during sleep( with medical paper).The fact that the patient can not normally blink, close his eyes makes their protection a top priority for a neurologist.

The tire also prevents the lower jaw from lowering.Physiotherapy is performed by an infrared laser, ultrasound with hydrocortisone.

A week after the beginning of the treatment course, anticholinesterase drugs( Neuromidine, Galantamine, Prozerin, Nivalin), massage and thermal procedures, therapeutic gymnastics, masks, paraffin, ozocerite and mud applications on the face, acupuncture( primarily pharmacopuncture) are additionally prescribed.

Surgical method of treatment - tarsorphia around the eyes - full / partial suturing of the eyelid edges or operation on the skull with implantation of a healthy nerve( very dangerous, because the effects are unpredictable).The latter usually represents an autotransplantation, when the operated one becomes a donor to himself, tk.The nerve is taken from his tongue.

Usually after the course of treatment the facial expression is restored completely, but sometimes there is a contracture - a cicatrical degeneration of the facial muscles.In order to get rid of it, do local injections of anti-tuberculosis drugs.

In some cases, there are inadequate contractions of different groups of facial muscles( twitching of the lips, eyelids) and / or asymmetry in the smile.

There are a lot of ways of healing, but the doctor chooses them "blindly", based only on similar cases.The main means of combating any disease is the elimination of its cause, and in the case of Bell's paralysis, it is not clear.

Preventive measures are not available due to an unequivocal cause


The complex of preventive measures is not developed, becauseThe cause of the disease has not been established.Most experts recommend strengthening the immune system, avoiding hypothermia and drafts, getting rid of infections in a timely manner, not getting craniocerebral injuries and preventing contractures.

Strengthen the facial muscles with special articulatory gymnastics and various mimic exercises.

Examples of exercises:

  • "Smile", exposing teeth with sound AND
  • "Tube" or "Hobotok" lips with sound
  • "Piglet" - "Tube", which moves from right to left and around the circle
  • "Rabbit" with clenched teeth and raised upper lip
  • "Fish" when you need to loudly clap your lips
  • Biting and scratching your cheeks and lips
  • Kisses
  • Cheeks blown simultaneously or in turn
  • Drawing by holding your pencil with your lips
  • Chewing movementsWith closed or open mouth

It is recommended to perform gymnastics three times - four times a day.It is necessary to gradually complicate the exercises, increasing the duration of each from 5 to 15 seconds.At first, the movements will be difficult, tense.Over time, it will pass, and facial expressions will become relaxed, coordinated.

Starting position: sitting in front of the mirror, the back is straight, the body is relaxed.Movements should be made qualitatively: accurately, smoothly, symmetrically.

The main measure of the prevention of any disease is to take care of your health, to treat diseases causing complications in a timely manner.

You will learn more about neuritis of the facial nerve from the program Live Healthily.

To whom Bell's paralysis struck, do not despair.Over time, it will heal practically without any consequences.It is important not to relax during the rehabilitation period, follow the doctor's instructions and restore your health completely.

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