Bell’s palsy is a mysterious condition in which one half of the face abruptly becomes paralyzed. This sudden paralysis may be preceded by pain behind one ear for a day or two, but it usually occurs quickly.
People with Bell’s palsy might experience a number of uncomfortable symptoms, including total paralysis or pronounced weakness on one side of the face. The weak side typically becomes flat and expressionless, and affected people might feel a heaviness or numbness in their faces (even though normal sensation remains). Other symptoms include a drooping appearance on the affected side of the face and impairment of tear and saliva function.
If the upper part of the face is involved, affected people may have problems with their eyes. Because they are unable to close their eyes, dryness is a problem. In extreme cases this dryness can result in eye damage or even blindness. To help avoid these problems, some physicians recommend the use of paper tape at night to keep the affected eye closed and lubricated. In addition, people with Bell’s palsy may experience loss of taste or abnormally enhanced hearing because the muscle that stretches the eardrum is paralyzed.
Most people with Bell’s palsy (about 80 percent) recover within a few weeks or months. Among those who do not recover fully, the affected side of their face may continue to be weak and droop. About one in sixty people will experience Bell’s palsy at some point in their lifetime. It can occur at any age, but is most common between the age of fifteen and sixty (Rowlands 2002).
Bell’s palsy is associated with presence of the herpes simplex virus 1 (HSV1), which suggests that reactivation of this virus in the facial nerve might be responsible for the condition (Rowlands 2002). According to the herpes theory, about 80 percent of Bell’s palsy cases are caused by reactivation of HSV1 or varicella zoster (a member of the herpes family). HSV1 is most commonly associated with oral lesions, as opposed to HSV2, which is most commonly associated with genital lesions. Varicella zoster is responsible for chicken pox in children and shingles in adults. The herpes virus can be transported to the facial nerve, where it may remain dormant until it activates and causes Bell’s palsy (Lambert 2004). Although this theory has yet to be proven, supporting evidence is strong enough that Bell’s palsy is often treated with antiviral drugs (e.g., acyclovir, famciclovir, and valacyclovir) used to kill the herpes virus. To date, although viral DNA has been found in the facial nerves of patients with Bell’s palsy, no studies have actually found actively replicating herpes viruses (Linder 2005). Those interested in learning more about the implications and varieties of herpes viruses should read Life Extension’s Herpes and Shingles protocol.
Other infectious diseases that may be associated with Bell’s palsy include Lyme disease, the common cold, hepatitis C, influenza, HIV, typhoid fever, and tuberculosis (Rowlands 2002).
No single test can diagnose Bell’s palsy. Instead, physicians diagnose the condition by first excluding other possible causes of facial paralysis (e.g., cancer, leukemia, bacterial infections, stroke, multiple sclerosis, head trauma, and other disorders). There are two classic characteristics of Bell’s palsy that help guide diagnosis (Ferri 2004; Smith 2004):
- The symptoms have a quick onset.
- It affects the entire half of the face (while stroke or cerebral tumor usually cause paralysis below the eye).
During the diagnosis, a few tests might be ordered to help exclude other conditions, including blood tests to check for diabetes, HIV, bacterial infection, and Lyme disease. In some cases, an x-ray might be ordered to check for a tumor in the head.