Bell’s Palsy and Facial Nerve Problems
Twitching, weakness, or paralysis of the face are symptoms of a disorder involving the facial nerve, not a disease in itself. Abnormal movement or paralysis of the face can result from infection, injury, or tumors, and an evaluation by your physician is needed to determine the cause.
Bell’s Palsy is the most common cause of sudden facial weakness. This disorder is probably due to the body’s response to a virus, which causes the facial nerve within the ear (temporal) bone swells. This pressure on the nerve in the bony canal damages it.
How Is Bell’s Palsy Diagnosed?
After an examination of the head, neck, and ears, a series of tests may be performed. The most common tests are:
- Hearing Test: Determines if the cause of damage to the nerve has involved the hearing nerve, inner ear, or delicate hearing mechanism.
- Balance Test: Evaluates balance nerve involvement.
- Imaging: CT (computerized tomography) or MRI (magnetic resonance imaging) determine if there is infection, tumor, bone fracture, or other abnormality in the area of the facial nerve.
- Electrical Test: Stimulates the facial nerve to assess how badly the nerve is damaged. This test may have to be repeated at frequent intervals to see if the disease is progressing.
What Treatments Are Available for Bell’s Palsy?
The three questions most often asked by the patient are: What is the cause (diagnosis)?, When can I expect recovery (prognosis)?, and What can be done to bring about the best recovery at the earliest possible moment (treatment)? In order to answer these questions, your doctor must perform an extensive evaluation to determine the cause and figure out which area of the facial nerve is involved, so the best treatment can be prescribed.
The results of diagnostic testing will determine treatment.
- If infection is the cause, then an antibiotic to fight bacteria (as in middle ear infections) or antiviral agents (to fight syndromes caused by viruses like Ramsay Hunt) may be used.
- If simple swelling is believed to be responsible for the facial nerve disorder, then steroids are often prescribed.
- In certain circumstances, surgical removal of the bone around the nerve (decompression) may be appropriate.
Ways To Help Your Recovery
When the facial nerve is paralyzed, considerable attention must be given to maintaining a healthy eye, which requires a constant flow of tears. These tears are spread out over the eye by blinking, but this action is diminished or eliminated in facial nerve paralysis patients. Diminished blinking and the absence of tearing together can reduce or eliminate the flow of tears across the eyeball, resulting in drying, erosion, and ulcer formation on the cornea, and possible loss of the eye.
Closing the eye with a finger is an effective way of keeping the eye moist. Use the back of the finger to prevent injuring the eye with the finger tip. Protective glasses or clear eye patches are often used to keep the eye moist, and to keep foreign materials from entering the eye.
If the eye is dry, you may be advised to use artificial tears to keep it moist. The drops should be used as directed by your doctor. You may have to put one or two drops in the affected eye every hour while you are awake, and place ointment in your eye at bedtime.
Patients with permanent facial paralysis may be rehabilitated through a variety of surgical procedures including eyelid weights or springs, muscle transfers and nerve substitutions. Some patients may benefit from a special form of physical therapy called facial retraining. Other medical treatments for complications of facial paralysis, including excessive motion of the face or muscle spasms, may involve surgical division of overactive muscles or weakening them through chemical injection. If these procedures are needed, your physician will discuss them with you.