It was a Scottish doctor Charles Bell who first documented the relation between the SEVENTH CRANIAL NERVE and the muscles of the face.
There is a seventh cranial nerve on each side of your face. The seventh cranial nerve comes from the brain and travels through a small opening in the temporal bone named the stylomastoid foramen. Any swelling in this area can decrease the space for the nerve. Conditions that cause inflammation or infection can affect the conduction of the Facial nerve. The virus that is most commonly responsible is the Herpes virus that is responsible for cold sores of the lip.
Each Facial nerve assists you to move the muscles on one side of the face. So patients with Bell’s have difficulty in moving facial muscles on one side of the face.
The symptoms of Bell’s Palsy/Facial paralysis
- Pain around the ear and jaw joint
- Drooping of the mouth on the affected side
- Inability to smile – lopsided smile
- Inability to wrinkle nose
- Inability to close the eyelid on the affected side
- Irritation of the eye on the affected side (eye dries out due to the inability to blink)
- Your eye tears more than usual
- Difficulty eating and drinking – drooling or food falling from mouth while chewing.
Some patients report twitching in the face, decreased sense of taste, sensitivity in their ear area, pain with chewing, and dryness of the mouth. Not all patients have the same level of paralysis or symptoms. 
Typical presentation of Bell’s (shared with patient’s permission)
The most important part of treatment is to see a doctor as soon as possible. Prescription drugs like cortisone and anti-viral medication can assist patients with Bell’s Palsy but these need to be prescribed as soon as possible, preferably within the first 72 hours. There is moderate level evidence that combining anti-viral with cortisone does not provide a better outcome than cortico-steroids alone. If there is a strong suspicion that you have a viral infection, your doctor will decide on the best treatment plan for you.
Patients need to sleep with an eye pad to prevent drying of the eye. Eyedrops can be prescribed to keep eye moist. Some patients find that they drool a lot while they sleep- This can be managed by placing an absorbent material on your pillow to keep the pillow dry.
Physical therapists can assist patients with Bell’s Palsy. Physical therapies, such as biofeedback, laser treatment, electrotherapy, massage and heat, are used to attempt to hasten recovery and improve facial function. When the available research on physiotherapy for Bell’s was reviewed, very few of the studies delivered any high quality evidence to prove that physiotherapy works superior to cortisone treatment.
On the other hand, it must be said there is no evidence that shows that it is harmful to receive physiotherapy for the condition either. It is important to offer patients the option of deciding whether they would like to attend physiotherapy for pain relief and for improvement of facial function. There is some low quality research evidence that tailored facial exercises can help to improve facial function. And your #physio can provide you with a #exerciseprogram tailored to your needs!
From clinical experience I must add that some patients find relief from the heaviness of the face with strategically placed strips of strapping plaster to support drooping areas. Patients also report relief from laser therapy and gentle massage. All patients feel empowered when they have exercises to do at home – it gives them a feeling of participating in their own care.
Your physio will help you with your facial paralysis.
Disclaimer: This article is to be used as patient information only. It does not replace a consultation with a medical professional. Patients should never self diagnose by reading an article. Visit your doctor immediately if you suspect Bell’s Palsy.