Diagnosis, Prognosis and Treatment of Bell's Palsy
The clinical appearance is enough for a prompt diagnosis of Bell's Palsy. But sometimes doctors prefer to perform a facial CT scan or take x-rays so as to rule out any fracture or even tumors, which might be compressing the nerve during its course.
Bell's Palsy should not be confused with stroke or head injury where the cause of the condition is known. Other rare cause of the seventh nerve palsy include - Sarcoidosis and Lyme disease.
Prognosis of Bell's Palsy
Full recovery takes place from the condition in 80% of the cases. The return of the full function is usually gradual and does not require much treatment.
Full recovery in majority of cases takes place within 2 months; however in some instances it may take up to 12 months. The symptoms start improving within 2 to 3 weeks.
In about 20% cases there maybe some residual weakness of some of the muscles of the face. It is rare to see no recovery at all.
Treatment of Bell's Palsy
Protecting the Eye from Dryness and Infection: Infections can cause ulcerations of cornea of the eye. Protection of eye is important and for this the following are preferred methods:
- Wear eyeglasses or goggles or an eye - pad to protect the eye.
- During the daytime - use eye drops can help keeping the eye moist.
- During the Nights - use Eye ointment.
- In patients confined to bed or at nights - A tape may be used to close the upper and lower lids.
Use of Steroids: The use of steroids is controversial in Bell's Palsy. Some of the research has shown that thee is no difference in the recovery between patients who receive steroids and those who don't. However some doctors feel that the steroid have the ability to reduce swelling and inflammation of the nerve and hence are useful for the first one to two weeks. If used it should be started early.
Use of Anti-viral drug - Acyclovir: Some doctors prescribe Acylovir with the steroid in order to take care of the Herpes infection if that is the cause of the condition.
Surgery is a rare late option: In the cases where the recovery from the palsy is poor and maybe more for cosmetic reasons then to enhance recovery of the nerve.
- A Textbook Of Oral Pathology, Shafer, Hine and Levy 4th edition 1999 Wikipedia
- Bell Charles. On the nerves of the face: being a second paper on that subject. Philos Trans R Soc London. 1829; 119:317-30 [As cited in Kelly EC (ed). Classics of Neurology. New York: Robert E. Krieger Publishing; 1971, pp. 75-89].
- Bell, Charles. On the nerves of the face: being a second paper on that subject. Philos Trans R Soc London. 1829; 119:317-30 [As cited in Kelly EC (ed). Classics of Neurology. New York : Robert E. Krieger Publishing; 1971, pp. 75-89].
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