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Bell's Palsy

Bell's palsy is the most common condition resulting in facial nerve weakness or paralysis. The condition is named after Sir Charles Bell, who first described the condition. The underlying cause of Bell's palsy is, at present, considered to be due to a herpes virus infection of the nerve. The herpes virus is dormant in our nervous system and then reactivates to cause Bell's palsy. The virus causes swelling of the facial nerve in its tight bony canal through the temporal bone of the earl. This swelling results in pressure on the nerve fibers and the nerve's blood vessels. Therefore, electrical impulse cannot travel along the nerve, and a weakness or paralysis of the face develops.

Left-sided Bell's palsy.

Treatment of Bell's Palsy

Treatment of Bell's Palsy is designed to decrease swelling and restore circulation around the nerve, so that the nerve fibers may again function normally. Medical treatment involves oral steroids (to reduce swelling) and, in some cases, oral antiviral pills (to prevent viral replication). Facial muscle exercises are also prescribed.

Surgical treatment for Bell's palsy is considered within the first 14 days of the onset of complete facial paralysis if the following criteria are met:

  • Unilateral, complete facial paralysis present
  • ENoG testing indicates a poor prognosis (> 90% degeneration compared to normal side)
  • Onset of complete facial paralysis developed within the past 14 days
  • General health adequate to undergo general anesthesia

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