Bell’s palsy is a neurological condition that is caused by a problem with the 7th cranial nerve, and is named after a Scottish surgeon and specialist in anatomy who first described the function of that nerve. Our former prime minister, Jean Chretien, has this condition. With Bell’s palsy, there is intermittent paralysis of the 7th cranial nerve. The 7th cranial nerve is responsible for facial movement and so when it is not working, as in Bell’s palsy, you look like you’ve had a stroke. The affected side of the face will have no muscle tone and will droop. When you smile, that side of the mouth will not go up. Bell’s palsy comes and goes, but is never completely cured.

Men and women are affected equally with Bell’s palsy. Age-wise, people in their 20’s and 30’s seem to be at higher risk for some unknown reason. There is a lifetime risk for all people of developing Bell’s palsy of 1%. Each year 1 in 5000 people in the United States are diagnosed with Bell’s palsy. You are at higher risk of having this problem if you get cold sores, have diabetes or the flu, or are pregnant. This is because it seems to be linked to the Herpes simplex I virus. There is some controversy over whether or not Herpes zoster, the virus responsible for shingles and chickenpox, might be the cause in some people. Both of these viruses like to lie dormant in nerve cells and reactivate in times of stress, etc. This is likely why Bell’s palsy comes and goes, like cold sores and shingles.

Bell’s palsy usually develops suddenly overnight where you wake up and are not able to move one side of your face. Usually you can’t close one eye. Further, your sense of taste may be different in some way. You may not be able to tear properly and you may have facial and ear pain on the same side. Most of the time everything happens at once, but it may worsen over the next week. It usually stops at that point. You may have trouble speaking physically, but there is no problem finding the right words, like with some strokes. There should be no confusion or difficulty with any other parts of the body except for the affected side of the face.

The most serious side effect from Bell’s palsy is permanent facial paralysis on the affected side of the face. This is uncommon as over 80—90 % of cases of Bell’s palsy completely or almost completely recover. People who are unlikely to recover are those who had trouble with tearing, had pain other than ear pain, are over 55 years old, or who had paralysis on both sides of the face. Paralysis of both sides of the face is rare, happening in only 1% of people with Bell’s palsy. People who don’t recover completely may also have problems with blinking, tearing, drooling, sensitive hearing, speaking, chewing, and tasting, among other things.

To diagnose Bell’s palsy often no tests are needed. Other more serious problems have associated symptoms in a different pattern than in this condition and your doctor will likely recognize this.

Treatment of Bell’s palsy is difficult. Often the affected eye is patched to protect it until symptoms improve. If a Herpes infection is suspected, the anti-viral medications are sometimes tried. Prednisone is often prescribed to decrease inflammation around the nerve. There is no way to prevent Bell’s palsy. Please see your family doctor if you are experiencing symptoms that you think may be Bell’s Palsy and they can help you from there.