Bell's Palsy

Home » Bell's Palsy » Overview, Anatomy, Incidence and Prevalence, Causes, Risk Factors

Overview

Bell's palsy is a neurological disorder caused by damage to the seventh cranial nerve, also known as the facial nerve, which results in weakness or paralysis on one side of the face. The paralysis causes distortion of facial features and interferes with normal functions, such as closing the eye and eating.

The onset of Bell's palsy is usually sudden. Many people wake up in the morning and find that one side of their face is paralyzed. Patients often fear that they have suffered a stroke, but Bell's palsy is not related to stroke. Milder symptoms include tingling around the lips or a dry eye, and usually progress quickly, reaching maximum severity in 48 hours or less.

Anatomy

The facial nerve controls the muscles that move the eyebrows, close the eyes, and move the mouth and lips. It also controls the tear glands, one of the salivary glands, and the taste buds in the front of the tongue.

Electrochemical signals are relayed between the brain and many facial muscles by 7000 nerve fibers that comprise the facial nerve. When the facial nerve is damaged, as in Bell's palsy, the action of each nerve fiber is disrupted. Because the facial nerve controls several functions, several symptoms occur.

Incidence and Prevalence

Bell's palsy affects about 40,000 people in the United States every year. It affects approximately 1 person in 65 during a lifetime. It is more commonly seen in young adults, and persons of Japanese descent have a slightly higher incidence of the condition. Bell's palsy is the most common cause of facial paralysis worldwide and one of the most common neurological disorders involving a cranial nerve.

Causes

Viral infections such as herpes, mumps, or HIV, and bacterial infections such as Lyme disease or tuberculosis can cause inflammation and swelling of the facial nerve that causes Bell's palsy. A tumor, skull fracture, or neurological condition caused by chronic disease (e.g., diabetes, Guillain-Barre syndrome) can also lead to Bell's palsy.

Risk Factors

Conditions that compromise the immune system, such as HIV, increase the risk for Bell's palsy. Stress, pregnancy, and diabetes are also risk factors. Diabetics are more than 4 times as likely to develop the disorder compared to the general population.

Other risk factors include the following:

• Bacterial infections such as Lyme disease or typhoid fever
  
• Neurological disorders such as Guillain-Barre syndrome, multiple sclerosis, and myasthenia gravis
  
• Traumatic injury to the head or face
  
• Tumor causing nerve compression
  
• Viruses such as influenza, the common cold, or infectious mononucleosis
  

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