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Bell's Palsy
Bell’s palsy is defined as rapid onset paralysis (72 hours from
first sign of weakness until complete or near-complete paralysis) of the
facial musculature on one side of the face, without an apparent cause.
Bell’s palsy affects all branches of the nerve, from the forehead
to the neck. A viral illness preceding the paralysis, pain around and
behind the ear, changes in taste, facial numbness, and tongue numbness
are all commonly associated symptoms.
The cause of Bell’s palsy is uncertain, though there is strong evidence
to suggest a viral cause, with most data pointing toward activation of
the herpes simplex virus (HSV) that lives in the geniculate ganglion,
a slight enlargement in the facial nerve. This virus infects most human
beings (85-90% of the population) early in childhood, but usually lies
dormant (giving no symptoms). When something triggers it, it activates
to give either cold sores, or perhaps Bell’s palsy.
The fact that Bell’s palsy appears to respond to antiviral and anti-inflammatory
medications further supports the relationship between HSV and Bell’s
palsy.
For recurrent Bell’s Palsy, or unsatisfactory / prolonged recovery,
see other options in our Interventions section.
Phases of Recovery
The recovery from Bell’s Palsy tends to follow one of two pathways.
There is a set of patients in whom recovery begins within three weeks
of the onset of paralysis, and who tend to recover fully. This represents
roughly 85% of all Bell’s palsy patients and may be referred to
as the “rapid recovery” group. A smaller set of patients experience
delayed or incomplete recovery, and go on to require additional therapy
in order to improve their outcome. This “delayed / partial recovery”
group represents roughly 15% of all Bell's palsy patients.
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