There are many health problems that not everyone knows about. This is the case of Bell's Palsy. Have you heard of it? Ana Santos Pinto, a neurologist from the Trofa Saúde Group, in an interview with Lifestyle ao Minuto, explains everything about the condition that paralyzes half of the muscles in the face.

It can affect "men and women equally" and, in most cases, "the effects are temporary". Fortunately, about "70 to 85% of patients achieve complete recovery after three to six months".

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What is Bell's Palsy?

It is the consequence of isolated damage to a peripheral cranial nerve, which we call the facial nerve and which causes half of the muscles in the face to become paralyzed.

Can it happen to anyone? Who is most at risk?

It can occur at any age and race, it affects men and women equally, but pregnant women, patients with diabetes or immunosuppressed patients are the highest risk groups.

Neurologist from the Trofa Saúde Group© Ana Santos Pinto

What are the most common causes?

Bell's Palsy is due to spontaneous inflammation of the facial nerve. The most common cause associated with this inflammation is a viral infection, namely by the 'Herpes Simplex' virus, which is the same virus responsible for cold sores. However, it can also be caused by other similar viruses.

How long does it take to get better?

When the treatment is carried out properly, the prognosis is very good, and we can observe improvements from the first 21 days and 70 to 85% of patients achieve complete recovery after 3 to 6 months.

Is it always a temporary problem? Is it possible that it will have long-term effects?

In most cases the effects are temporary, but there are cases in which the recovery is not complete and a moderate or severe weakness of the facial muscles may remain for the rest of the patient's life. One of the complications of these more severe cases is the development of abnormal movements in the face when we smile or close our eyes, which we call spasms. They occur because after the inflammation, the nerve 'grows' back in an abnormal and disorganized way.

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What are the most common symptoms?

Paralysis of half of the muscles in the face, causes an asymmetry evidenced by sagging of the eyebrow, deviation of the outer corner of the mouth and difficulty closing the eye on the same side. It can also be associated with discomfort in the ear area and a sensation of amplification of sounds, which we call hyperacusis. Some people may also experience a lack of taste on the front of the tongue.

Is it a condition that is easy to confuse with others? Which ones?

Bell's Palsy is the most common cause of facial paralysis, but it is not the only one. It can be confused with an infection caused by the 'varicella-zoster' virus, which is differentiated by the appearance of vesicles in the auricle. Complicated otitis media can also cause facial paralysis, as can tumors of the inner ear.

Less frequent conditions such as autoimmune inflammatory diseases and brain tumors can also affect the facial nerve. On the other hand, diseases as frequent as strokes (Cerebrovascular Accidents) can manifest with facial paralysis, however they are usually accompanied by other symptoms such as difficulty speaking and mobilizing a limb.

Is there any way to prevent this problem?

No, unfortunately, it is not a condition that can be avoided or prevented.

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Is it always necessary to consult a doctor?

Yes, even considering cases in which the symptoms are mild and it may not even be necessary to carry out the treatment, evaluation by a doctor is essential to exclude the atypical signs that lead to other similar diseases and also to establish early treatment in cases that require it.

How is the treatment done?

Although there is no cure, treatment can help in the faster recovery of symptoms, especially if started in the first days of evolution. It is based on corticosteroids (potent anti-inflammatories) and antivirals in cases of severe paralysis or presence of risk factors. It is essential to protect the eye when we cannot close it, to avoid corneal injuries. Physiotherapy is complementary to the treatment and can help in severe cases or late recovery.

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