Face paralysis

Bell’s palsy causes sudden weakness in the facial muscles. As a result, half of your face looks lowered. The smile becomes one-sided, while the eye opposes the closure on this side of the face. Bell’s palsy, also known as facial paralysis, may occur at any age. The exact cause is not known, but is believed to be the result of swelling and inflammation of the nerves that control the muscles on one side of the face. Also, there may be a reaction that occurs after a viral infection.
In most people, Bell’s paralysis is temporary. During treatment, symptoms can be reduced within a few weeks, while for complete recovery it takes about six months. However, a small number of people still have some symptoms of the disease after treatment. Rarely, Bell’s palsy may reappear after healing.

Causes of Bell’s palsy
Although the exact cause of Bell’s palsy is not clear, it is often associated with exposure to viral infections. Viruses that are closely related to Bell’s palsy, and potentially cause it are:
Boils and genital herpes (herpes simplex),
Shingles (herpes zoster),
Infections caused by cytomegalovirus,
Respiratory diseases (adenovirus),
Rubella, mumps and influenza (influenza B).

Symptoms of Bell’s palsy
Signs and symptoms of Bell’s palsy appear suddenly, and include:
The quick onset of mild weakness on one side of the face,
Appears for a few hours a day,
On the affected side of a person’s face, and it is difficult for a person to laugh and to close the eye on that side,
Pain around the jaw and behind the ear on the affected side,
Increased sound sensitivity on the affected side,
Facial relaxation and difficulty in controlling the facial muscles,
A headache,
Reduced ability to sense taste,
Changes in the amount of tears and saliva secretion,
Rarely, Bell’s palsy can affect the nerves of both sides of the face.

Treatment of Bell’s palsy
Most people who have Bell’s palsy recover completely – with or without treatment. The same type of treatment isn’t suited for everyone. Your doctor may recommend medication or physical therapy to accelerate recovery. Surgery is a rare choice.

Drugs commonly used to treat Bell’s palsy:
Corticosteroids such as the prednisone are potent anti-inflammatory agents. They can reduce swelling of the facial nerve. Their effect is the best if they are used within a few days after the symptoms have occurred,
Antiviral drugs are used if it is established that paralysis was caused by the virus, so they are used to prevent further progression of the infection. This treatment is only used if the facial paralysis is not severe.

Furthermore, your physiotherapist can teach you how to massage your face and recommend specific exercises for your facial muscles to reduce symptoms and stop the reappearance. Rarely, plastic surgery is required to correct the permanent problems of the facial nerve. Usually temporary loss of facial sensation or inability to move usually one half of the face causes the inability to close the eyes or mouth of that half face.

In some cases, the symptoms of facial paralysis appear suddenly within 24 hours.
In other cases, including the ones where the disease was caused by acoustic neuroma, symptoms may occur gradually and include:
Partial or complete paralysis of the muscles on one side of face,
Ear pain on the affected side,
Lowering of the lip angle and sometimes salinization,
Inability to lower the lid on the affected side and tears,
Disorder of taste.

If the facial paralysis is very expressed, you may find it difficult to talk and eat. In rare cases, the sounds sound unnaturally in the ear on the affected side. If the eyelid cannot be lowered, the eye can be infected, which in turn leads to ulceration of the cornea, a clear part on the front side of the eye. If the cause is herpes, a rash appears on the face.

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PhD Milica Čelebić

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