What is Bell’s Palsy?

So What Is Facial Paralysis?

Bell’s Palsy-Idiopathic Peripheral Neuropathy Of The Facial Nerve Is A One-Sided Paralysis Of Facial Muscles.

Bell’s Palsy Is The Second Most Common Disorder Of The Peripheral Nervous System. On Average, 25 People Out Of 1 Lakh Others Will Experience Bell’s Palsy Every Year. There Are Multiple Causes Due To Which One May Experience Bell’s Palsy. The Commonest Being:
1. Local Overcooling (Sleeping Under The Air Condition, Driving A Car With Both Windows Open, Riding A Bicycle With Wet Hair In Cold And Windy Weather.)

2. Suppressed Immune System.

3. Stress Or Lack Of Sleep.

4. Viral Infection Such As Herpes Simplex Virus.

5. Bacterial Infection Such As Lyme’s Disease.

6. Hypertension, Diabetes Mellitus, And Last Week Of Pregnancy.
When We Talk About Recovery, 70 To 85% Of People Who Suffer From Bell’s Palsy Will Recover Completely. The Normal Recovery Time Is 2 To 5-6 Weeks After The Onset But 15 To 30% Of Bell’s Palsy Cases Who Have Severe Nerve Damage Do Not Recover Completely. Recovery In Such Cases Happens Slowly And Can Take From 6 Months To 1 Year Or More. Usually, These People Are Left With Various Residual Complications. Some Of The Common Residuals Of Bell’s Palsy Are:
1. Weakness Of Facial Muscles.

2. Facial Asymmetry At Rest Or Due To Facial Movements.

3. Incomplete Closure Of Eye.

4. Bell’s Phenomena (Crocodile Tears).

5. Increased Tone Of Lower And Mid Face Muscles On The Healthy Side.

6.Contractures Of Facial Muscles On The Affected Side.

7. Synkinesis (Involuntary Contracture Of Facial Muscles That Accompany Voluntary Movement).

8. Rigidity Of Facial Muscles.

9. Pulling Sensations In The Face And Neck.

10.Mass Movements During Speech, Eating, Movement, Etc….

11.Chronic Facial Pain In Certain Points Or Areas Of Face, Head And Neck.

12.Headaches On The Affected Side Often Cannot Be Relieved By Medical Painkillers.
Most Of The Time, When You Go To A Doctor Or Physiotherapist, The Common Line Of Treatment Is Electric Stimulation And Exercise. Many Times, You Are Prescribed To Do Active Facial Exercises On Your Flaccid Paralyzed Muscles. Forceful Contractions Or Active Exercises Of Facial Muscles In The Flaccid Stage Cause More Damage Than Doing Good To Your Facial Muscles. These Forceful Movements Increase The Risk Of Synkinesis Which Is One Of The Most Devastating Complications Of Facial Paralysis.
Course Of Recovery Of Facial Nerve:
It Has Been Consistently Seen In Researches That Bell’s Palsy Recovers On Its Own, Just With The Help Of Medicines Within A Timespan Of 3 Months Without Any Additional Treatment.
The Tone Of The Facial Muscles Is The First To Return Back. The Tonic Muscles Of The Face Recover Faster Than The Postural Muscles, Gradually Following Changes Are Seen As A Person Recovers From Bell’s Palsy:
1. Nasolabial Fold Becomes More Pronounced.

2. The Sagging Of Mouth Corners Reduces.

3. Hanging Of Eyebrows Reduces.

4. The Smile Line Becomes More Straight.
The Recovery Of Voluntary Muscles Is Slower Hence The Movements Come Slower Than Tone. As Dynamic Or Postural Motor Neurons Are Thicker And More Myelinated, It Recovers A Longer Regeneration Time.
The People That Show A Delay In Recovery Are Mostly The Ones Who Don’t Start Their Medication Before 72 Hours Of Onset Or Who Have Got Facial Palsy Due To A Severe Infection From A Virus, Bacteria, Trauma Or A Tumour. The People Who Even Though Recover From Bell’s Palsy Show Some Residuals After 3 Months And The Reason Behind That Still Stays Unclear.
It Has Been Clearly Manifested That People Who Show Delayed Recovery, Developed Secondary Complications Like:
1.Synkinesis (Mass Movements.)

2.Contracture Of Facial Muscles.

3.Pronounced Nasolabial Fold (Hyper Tone Of The Smile Muscle.)

4.Mouth Corner Moved Side Ward And Upward (Hyper Tone Of Smile Muscle.)

5.Acquired Ptosis (Droopy Eyelids.)

6.Involuntary Contracture Of The Platysma.
Bell’s Palsy Is A Tricky Problem As It Involves Facial Muscles In It That Have Got 2 Control Centers. One Is The Logical Center Of The Brain (Voluntary Movement Center) And The Factor Of Emotions (Limbic System). Since The Brain Is Constantly Changing And Learning New Things, It’s Very Easy For The Brain To Develop Different Movement Patterns While It Is In The Stage Of Facial Paralysis Which Gradually Turns Out To Be Synkinesis. Therefore It Is Important That The Person Who Suffers From Bell’s Palsy Understands The Problem, Collaborates With His Or Her Healthcare Professional To Work On Its Recovery.
It Is Very Important That Bell’s Palsy Is Rehabilitated Basis The Timeline Of The Symptoms And The Time From Which The Condition Is Developed. In The Bell’s Palsy Rehabilitation Program We Have Created A Timeline-Related Rehabilitation Protocol That Allows The Facial Muscles To Restore Their Movements In A Gradual And Progressive Way.
Bell’s Palsy Rehab Program Are Thus Divided Into 3 Categories:
1. Acute Or Flaccid Stage.

2. Paretic Or Weakness Stage.

3. Synkinesis Stage.
Each Stage Has Got Certain Do’s And Don’ts Rules To Follow, Home-Based Relaxation Practices, Massage Practices, And Mobility Exercises Depending On The Available Muscle Strength. Unlike Conventional Rehab Methods Where All The Set Of Exercises Are Given To The Patient On Day One Of Bell’s Palsy Episode, Patients At The Bell’s Palsy Rehab Program Gradually Do Their Exercises As They Incrementally Regain Their Facial Movements. With This Method, The Chances Of Development Of Secondary Complications Of Bell’s Palsy Reduces And The Patient Is Able To Attain A Better Facial Recovery.

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