Bell’s Palsy

What is Bell’s palsy?

Bell’s palsy is a paralysis or weakness of the muscles on one side of your face. Damage to the facial nerve that controls muscles on one side of the face causes that side of yourface to droop. The nerve damage may also affect your sense of taste and how you make tears and saliva. This condition comes on suddenly, often overnight, and usually gets better on its own within a few weeks.

Bell’s palsy is not the result of a stroke or a transient ischemic attack (TIA). While stroke and TIA can cause facial paralysis, there is no link between Bell’s palsy and either of these conditions. Palsy simply means weakness or paralysis.

What causes Bell’s palsy?

The cause of Bell’s palsy is not clear. Most cases are thought to be caused by theherpes virus that causes cold sores.1

In most cases of Bell’s palsy, the nerve that controls muscles on one side of the face is damaged by inflammation.

Many health problems can cause weakness or paralysis of the face. If a specific reason cannot be found for the weakness, the condition is called Bell’s palsy.

What are the symptoms?

The main symptom of Bell’s palsy is a sudden weakness or paralysis in one side of your face that causes it to droop. This may make it hard for you to close your eye on that side of your face.

Other symptoms include:


Eye problems, such as excessive tearing or a dry eye.

Loss of ability to taste.

Pain in or behind your ear.

Numbness in the affected side of your face.

Increased sensitivity to sound.

How is Bell’s palsy diagnosed?

Your doctor may diagnose Bell’s palsy by asking you questions, such as about how your symptoms developed. He or she will also give you a physical and neurological exam to check facial nerve function and rule out more serious causes of facial paralysis.

How is it treated?

Most people who have Bell’s palsy recover on their own in 1 to 2 months. But a small number of people may have permanent weakness of the muscles on the affected side of the face.

Your doctor may prescribe antiviral drugs, such as acyclovir, if he or she believes that Bell’s palsy is caused by a virus. If your doctor suspects that Bell’s palsy is caused by inflammation, you may be given corticosteroids, such as prednisone, to reduce the inflammation.


Related To Category: Adult

Symptomatology of Blepharospasm

Blepharospasm is a focal dystonia characterized by excessive involuntary contraction of the orbicularis oculi muscles, leading to repetitive blinking or sustained closure of the eyelids.1

Blepharospasm usually begins gradually with excessive blinking and/or eye irritation.2

Blepharospasm consists of abnormal blinking, or eyelid tic or twitch resulting from any cause, ranging from dry eye to Tourette’s syndrome to tardive dyskinesia.

Blepharospasm may be accompanied by cervical dystonia. It can also occur with dystonia affecting the mouth and/or jaw (oromandibular dystonia, Meige syndrome). In such cases, spasms of the eyelids are accompanied by jaw clenching or mouth opening, grimacing, and tongue protrusion.

Benign essential blepharospasm, as distinguished from the less serious secondary blinking disorders, is both a cranial and a focal dystonia.

Blepharospasm can be triggered by exposure to bright lights, watching television, reading, driving, fatigue, and emotional tension.

Contractions may be ameliorated by concentrating on a specific task2 or by using sensory tricks such as touching the forehead or the eyebrow or talking.

As blepharospasm progresses, it may occur frequently during the day. The spasms disappear in sleep and may not appear until several hours after waking.

As blepharospasm progresses further, the spasms may intensify to the point that the patient is functionally blind; the eyelids may remain forcibly closed for several hours at a time.

Epidemiology of blepharospasm

Age of onset is typically in the fifth or sixth decade.

Women are more than 2 times more likely to be affected than men and are typically older at onset.

Etiology of blepharospasm

Primary, essential, or idiopathic blepharospasm, often referred to as benign essential blepharospasm, is not associated with any known etiology.

Prior head trauma with loss of consciousness, family history of dystonia, and prior eye disease may also increase the risk of developing blepharospasm.

Dry eye may precede and/or occur concomitantly with blepharospasm and/or trigger the onset of blepharospasm in susceptible persons.

Blepharospasm treatment options

OnabotulinumtoxinA is a treatment of choice for blepharospasm.

Treatment alternatives may include trihexyphenidyl, clonazepam, baclofen, and tetrabenazine. Patients unresponsive to medications are candidates for myectomy of the eyelid protractors.

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