What is Bell Palsy? What are the symptoms and treatment methods?

Bell Palsy is the loss of movement in facial mimic muscles due to nerve problems. It is known as facial paralysis. It can be observed on one or both sides of the face and is called facial paralysis in the medical literature. The most common causes of facial paralysis are inflammation of the facial nerve in facial mimic muscles, head trauma, stroke, and head and neck tumors. Paralysis may pass in a short time or may persist for a long time, depending on the causes.

Why Does Facial Paralysis Occur?

Facial paralysis; It can occur due to different reasons such as head trauma, cerebral vascular occlusion, head and neck tumors, facial nerve damage. The causes of facial paralysis are as follows;

• Bell's Paralysis
• Stroke

Other causes that may occur

We will explain them in detail in sub-headings.

Bell's Paralysis

The most common cause of facial paralysis is a clinical condition called Bell's palsy. Although Bell's palsy affects only one side of the face, it is a facial paralysis that develops suddenly and the cause of which is not yet known. When detailed, no obvious cause such as tumor or head trauma is found.

It is thought to occur due to the formation of edema in the facial nerve region and compression of the bone structures through which it passes. The facial nerve is presumed to be linked to viral infection. Nearly 90% of patients with Bell's palsy and facial palsy recover completely within approximately six months.

Stroke

A very serious cause of facial paralysis is stroke. In the stroke-related condition, the nerve cells that control the facial muscles develop by being damaged in the brain. There is no direct damage to the facial nerves in facial paralysis caused by stroke. For this reason, facial paralysis is caused by brain damage and the inability of messages to occur correctly to the facial nerve. The reasons for the damage to the brain cells as a type of stroke;

• Oxygen deficiency
• We can list it as excessive pressure in the brain cells area due to bleeding.

Other Causes Occurring
Other causes of facial paralysis can be listed as follows:

• Brain damage with skull fracture
• Occurrence of facial injuries
• Presence of head or neck tumors
• Occurrence of middle ear infection
• Other damage to the ear
• Lyme Disease: It is known as a bacterial infection disease that is transmitted to humans due to tick bites.
• Ramsay-Hunt Syndrome is among these reasons. This syndrome is a recurrent activation of the varicella zoster virus, which is the causative agent of chickenpox. If the facial nerve is damaged as a result of this 
• disease, facial paralysis occurs.
• Other causes are autoimmune diseases such as multiple sclerosis and Guillain-Barré syndromes that affect the brain and spinal cord.
• Surgical Reasons: For example, damage to the facial nerve during the removal of acoustic neuroma or facial nerve tumor, or during the operation of the parotid gland, which is the largest of the salivary glands.
• Abnormal development of facial nerves or facial muscles in the uterus
• Congenital facial paralysis can be observed due to congenital syndromes such as Moebius, Charge or Melkersson-Rosenthal syndromes.

Birth Trauma: In some babies, facial nerve injuries may occur due to the use of forceps during birth or facial presentation. As a result, temporary facial paralysis occurs. 90% of babies who experience this type of nerve injury fully recover without treatment.

Facial Paralysis Symptoms

There are different symptoms in facial paralysis, and these vary from person to person depending on the reasons.

Conditions that occur in the symptoms of Bell's palsy:

• Unilateral facial paralysis
• Losing control of blinking or forehead creases on the affected side
• Dwindling tears
• Formation of sagging in the mouth
• Involuntary movements, such as muscle twitching
• Altered sense of taste on the affected side
• Occurrence of speech disorde
• Excessive saliva production
• Difficulty eating or drinking
• Pain in or behind the ear
• Pain around the jaw joint
• Hypersensitivity to sounds in the ear of the affected party
• Occurrence of headache

The symptoms here occur in the affected area. In rare cases, Bell's palsy can be seen to affect the nerves in both areas of the face.

Symptoms of Facial Paralysis Due to Stroke

Patients with facial paralysis due to stroke generally show the same symptoms encountered in Bell's palsy. But with a stroke, there are some additional symptoms. We add the following symptoms to the symptoms seen in Bell's palsy;

• Occurrence of changes in consciousness
• Experiencing confusion
• Seeing dizziness
• Experiencing balance problems
• Occurrence of vision problems
• Having epileptic seizures
• Weakness in the arms or legs in an area of the body

Contrary to Bell's palsy, patients with facial paralysis due to stroke show protection from the ability to wrinkle their forehead with blinking.

How Do We Diagnose Facial Paralysis?

Regarding the diagnosis of facial paralysis, the doctor evaluates the muscle movements of the patient by asking him to make gestures such as raising his eyebrows, blinking, smiling, frowning. In order to make a differential diagnosis, electromyography (the test that checks the health of the muscles and the nerves that control them), imaging scans such as MRI and CT, and blood tests can be performed. The cause of facial paralysis is tried to be determined through tests.

Facial Paralysis Treatment

Treatment of facial paralysis is determined in accordance with the causes of occurrence. The generally known aspects are as follows:

The symptoms of facial palsy improve over time, whether or not they receive treatment for the majority of people with Bell's palsy. In addition, studies have shown that when facial palsy occurs, taking steroids such as prednisone and antiviral drugs by mouth immediately can help in full recovery. In addition, the application of physical therapy will help strengthen the muscles and prevent permanent damage.

For those who do not fully recover, help from plastic surgery may be sought to correct incompletely closed eyelids or to correct crooked smiles.

The greatest danger in facial paralysis is possible eye damage. Bell's palsy generally prevents one or both eyelids from closing completely. With the problem of blinking, the cornea can dry out and foreign particles can enter the eye and cause damage. Therefore, people with facial paralysis have to use artificial tears throughout the day. It may be necessary to wear an apparatus made of extra transparent plastic in order to keep the eye moist and protect it.

How Does Facial Paralysis End?

Medical methods such as acupuncture, together with the medical treatment created under the control of a doctor, can produce effective results for facial paralysis. It may be beneficial to apply an acupuncture treatment with an average of 10-12 sessions in the first 6 months after facial paralysis.