My own research into many sites, information is pieced together

Also called facial palsy, this is a disorder involving sudden facial drooping and decreased ability to move the face. It is caused by damage to cranial nerve VII. Bell's palsy is an acute form of cranial mononeuropathy VII and is the most common form of this type of nerve damage (peripheral neuropathy). Statistics indicate that the disorder affects approximately 2 out of 10,000 people, however, the actual incidence is likely to be much higher (around 1 out of 500 to 1,000). The disorder is a mononeuropathy (involvement of a single nerve) that damages the 7th cranial (facial) nerve, the nerve that controls movement of the muscles of the face. The cause is unknown. In some cases, the disorder is presumed to be associated with inflammation of the facial nerve where it travels through the bones of the skull. It may also be caused by head injury, tumor, hypertension, or infarction.

Symptoms

  • Pain behind or in front of the ear
  • May precede weakness of facial muscles by 1-2 days
  • Impairment of taste
  • Sensitivity to sound
  • Headache
  • Face feels stiff
  • Face feels pulled to one side
  • Difficulty with eating and drinking
  • Change in facial appearance
  • Facial droop
  • Difficulty with facial expressions, grimacing
  • Facial paralysis of one side of the face
  • Difficulty with fine facial movements
  • Drooling

    In many cases, no treatment is necessary. The goal of treatment is to relieve the symptoms. Corticosteroids may reduce swelling and relieve pressure on the facial nerve for some persons. Corticosteroids must be given early to be most effective; preferably within 24 hours of the onset of paralysis. Lubricating eye drops or eye ointments may be recommended to protect the eye if it cannot be closed completely. The eye may need to be patched during sleep to protect it. Surgical procedures to decompress the facial nerve have not been shown to routinely benefit people with Bell's palsy.

    The outcome varies. Approximately 60% to 80% of cases resolve completely within a few weeks to months. Some cases result in permanent changes. The disorder is not a threat to life.

  • The RA or Resident Assisstant of my freshman dorm was afflicted with a permanent form of Bell's Palsy. When I first saw her, I admit with shame that I was shocked. I thought she was ugly, I wondered what horrific event had caused half of her face to go slack like that. I didn't have the nerve to ask her, though, and so simply tried to ignore it.

    I didn't have to try for long. She was such an incredible person, I soon grew to enjoy her company so much that the disfigurement ceased to become noticable. In fact, it was even beautiful. She could only smile with one half of her mouth, but that smile was radiant. I envied her vibrance and her multitudinous talents. She wrote songs, she played the guitar, she sang, she was incredibly spiritual, she was smart, self-confident, and fun.

    How I wanted to be like her, Bell's Palsy and all.

    I got bells palsy earlier this year. I had just got my results for my end of year exams at Uni. and my mum came to pick me up from my house.

    On the drive home, I had a bottle of flavoured water and I could only taste on one side of my tongue. I thought this was odd at the time and didn't think anything of it again.

    The next day I was surfing the net and my right eye was watering really badly. I thought I was just tired, besides I had spent ages on the net and you know how your eyes start to hurt anyway.

    The next morning after that I was brushing my teeth and kept hitting my lip on my right side. I was confused and tried opening my mouth further but couldn't. Looking at myself in the mirror I realised that I couldn't blink my right eye or flare my right nostril. I went and told my mum and she said, "Oh, you've got bells palsy", she'd had it before and so recognised the symptoms.

    We phoned NHS direct who were really helpful and told us to go to A&E anyway.

    At A&E, I saw the triage nurse and was awarded high priority so went straight in to the doctor. After a few face-pulling tests he sent me on my way with a tube of Chloramphenical to treat my eye.

    Bells Palsy is a paralysis of one side of the face (usually. Bilateral palsy can occur but is extremely rare) caused by an infection, usually viral. The nerve affected is the VII cranial nerve, which was studied in great detail by the Scottish surgeon Sir Charles Bell, hence the name. It can also occur due to mechanical damage.

    Apparently diabetics are four times more likely to develop bells palsy, which is funny because my girlfriends mum, thinks I am diabetic.

    About one in 5000 people suffer with Bells Palsy during their lifetime and it affects both sexes and all races equally.

    About 50% recover completely within a short time and 80% within a year.

    Bells Palsy doesn't hurt. The only pain I had was behind my ear and must have been due to mechanical pressure from the infection. The most important thing to remember is your eye on the affected side.

    Because you can't blink you are at risk of picking up a secondary infection in the eye. The Chloramphenical is an antibiotic and was prescribed to prevent any infection. You have to apply the cream and then tape your eye shut. It can be quite frustrating when your eye won't stay closed.

    You do get funny looks from people and some people who develop Bells Palsy actually get quite down about it. I'm a very easy going person, I didn't mind what people thought of what I looked, but even I felt a bit down at times. I was thinking along the lines of 'What happens if it doesn't go away?'.

    My Bells Palsy went in a few months but even now if I'm watching a film or eating, my right eye will water a lot. I sometimes also get a brief cramp when I yawn. I don't know if it will clear up 100% but I'm not worried.

    A few thing that I thought were quite interesting: The way your forehead wrinkles change shape and completely go on the one side even after only a couple of days. Freaking people out when you sneeze, because only one of you eyes can close. It dispels the myth that if you hold your eyes open they will pop out. Also, I got to wear a patch for a couple of weeks.

    Well I hope that this is helpful if you have developed Bells Palsy. My advice is not to worry, do some research on the net. There are plenty of resources available. One of the best is www.bellspalsy.ws

    Bell's Palsy is a neurological disorder that results from an inflammation of the facial nerve (the seventh cranial nerve -- enjoy your mnemonics, brodudes). Basically it just decides to get all inflamed for no known reason, and then the poor individual with the nerve with the bad attitude gets to enjoy having half their face just randomly not work. There's some evidence that it may occur in the wake of viral infections, or major exposure to cold, but basically, it's just for no goddamn reason.

    You may not realize how much you count on your face working right. I very quickly got sick of biting my goddamn lip when I tried to eat, and I assumed eating ice cream would work well. No chewing, right? Well, fuck me, because I can't even goddamn close my stupid lips around a spoon. At least I can still manipulate my tongue effectively. I have between weeks to months to forever ahead of me where I make excuses not to eat near anyone due to this drooly disability.

    Things that should still work okay

    For the sake of the dumb morons like me who go around internet-diagnosing ourselves, let me point out some things to worry about. If you have any trouble swallowing, it's not Bell's Palsy. It's something else. And it's serious. Also, your tongue should work, but it's common to note a lack of taste sensation on one side. That's fine, but you should still be able to use it to move food around in your mouth and form a bolus and swallow. If you can't, it's not Bell's Palsy. Jesus, get yourself under control, okay?

    If your neck is at all stiff, this is a symptom of meningitis, and you need to be in an ER yesterday. Headache is a bad sign, too. Some achiness is normal in the affected ear and jaw, but not a headache. That's a sign that it may be something else.

    Obviously part of your differential diagnosis is basic stuff to confirm you're not having a massive stroke. You should be able to speak coherently and clearly -- you may have to adjust a little bit cause of your fucked up, uncooperative lips, but most of the articulatory organs are not enervated by the facial nerve, so you should be able to speak pretty clearly. If your speech is slurred, or if it's incoherent or confused, you definitely need an ER.

    Weakness is expected in the face, extending from the eyebrow to the ear to the jaw on the affected side. If you have weakness elsewhere in the body, you don't have Bell's Palsy, you're just having a stroke. Get to an emergency room.

    You should still be able to play the piano at least as well as you could before. If you have run into sudden difficulties playing the piano, get medical help immediately. On the other hand, you probably can't whistle for shit, much less play a woodwinds instrument. Sorry about that.

    Eye protection

    So, then, contacts are kinda out of the question. And I fucking hate wearing glasses. But you have to be able to blink properly to wear contacts safely. My right eye closes most of the way, if I close my left eye with it. But, really, not convincingly. That was one of the first symptoms I noticed. It didn't seem like my right eyelid was making a good seal. The solution, fortunately, is simple. All you have to do is hit your affected eye with artificial tears every hour at minimum, and stick eye ointment in it at night (which is basically just Vaseline -- did you know it was okay to stick some sort of sterile Vaseline in your eyes? I sure fucking didn't! Don't try just rubbing a jar of regular Vaseline up in there, though.) And then, all you have to do is tape your affected eye shut.

    I have developed a method involving first aid tape. It doesn't rip my eyelashes out! Some people use gauze pads on their eyes but I'm not convinced it'd work in my case. So a nice little X of tape over the eye, plus three or four pieces of accessory tape until my eye felt securely shut. I have to do this, because I can tell my eye is gonna flip open at night if it's not well-contained, and I'd rather not get permanent corneal damage. Then I stick my pirate eyepatch on because I feel I have earned at least this much. Also I don't want to rub the tape off on my pillow and find my eye unprotected.

    Once my doctor was satisfied that the Bell's Palsy diagnosis was correct, she was most concerned about eye protection. I had already taped my eyes shut the night before because blinking just didn't seem to work right; I found out that doing so, in fact, is a mainstay of treatment, as is the frequent use of artificial tears during the day. I can't fully blink, so I've been applying artificial tears and holding my eye shut for a moment to make sure the liquid has a chance to distribute itself. I've still got full sensation, so I'm not worried about damage occurring without noticing, but without some effort to protect it, the cornea can easily dry out or get scratched so it's vital to pay attention to it, and to do something about it when the eye feels dry.

    Eating

    Don't eat in front of people. I don't care how suave you usually are, you can't pull this shit off anymore. I recommend that you eat lunch in your car in your work parking lot, crying a little. If you have diminished taste sensation, the bit of extra salt may be welcome! Incidentally, I'm finding the effects on the taste of food unpredictable. Sometimes things taste astonishingly bland.

    I sort of figured that soft foods would work best. Wrong. I mentioned my failing at eating ice cream. Soup doesn't work either. Pasta's tricky. Soft foods are bad, because you need your lips to maneuver them off the utensil. It's actually easiest to eat stuff I can deliver to my mouth by hand. Nachos are working reasonably well this afternoon. Gently cooked vegetables are working great too. It's really hard to avoid getting sauces on my face, so I'm avoiding anything like that.

    Facial expressions

    Even when perfectly relaxed, my face has an obvious droop on the right side. My eyebrow is well below the left one, and obviously the difference is exaggerated if I try to raise my eyebrows. I'm trying to remember not to make normal friendly facial expressions since my best attempt at a smile looks, at best, rather sardonic.

    This is one of those times when I'm glad to be a dude, since random-ass strangers are less likely to come up and demand that a smile for them in the street than if I were a woman. On the other hand, if someone did, I suppose I wouldn't actually need to worry that much about being polite, would I?

    Other activities

    We'll have to reschedule, gentlemen.

    Recovery

    It's usually temporary! It generally clears up within a few weeks to a few months; it's unusual for symptoms to remain after a year, and if they do, they've generally become somewhat less severe. According to that other collaborative database, in the great majority of cases, facial function starts returning within three weeks.

    Odds of recovery are worse for elderly patients. The syndrome most often occurs in younger people, though. Steroids taken within a few days of the first symptoms (and the sooner the better) are associated with better outcomes, although most people have full recovery even without treatment.

    Review

    It's less unpleasant than the flu, much less a migraine or an episode of Here Comes Honey Boo Boo, but longer lasting. I can think of numerous things I would recommend before trying this.

    Updates

    Okay, so as of around January 6, which was a day less than two weeks after I started noticing the earliest symptoms (on Christmas day), I felt some tiny minor motion in my stupid face again, and with a close look in a mirror, I could actually see my cheek moving. No one I showed it to could see it, though.

    As I write this, now, on January 12, my coworkers have spontaneously observed that my face looks more normal -- and it does; it's still slightly droopy when totally relaxed, but much less obviously so. My smile is somewhat more like a normal one -- it looks asymmetric, but not like some weird sarcastic display. I'm having an easier time eating and I don't smear quite as much toothpaste on my face when I brush my teeth. I'm having to worry a lot less about my eye, although I still tape it shut at night. (I scratched my cornea on New Year's Eve eve, so I'm a bit gunshy.) But I'm not elaborately protecting it with cotton balls and gauze anymore. Just a couple bits of first aid tape.

    Update, January 18: I can totally, kind of whistle again! It requires a lot of effort and I can't narrow my embouchure enough to hit the high notes, but still, a relief indeed.

    Bell's palsy.

    Paralysis of the facial nerve, producing distortion of one side of the face.

     

    © Webster 1913.

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