The Probert Encyclopaedia of Medicine

BELL'S PARALYSIS

Bell's paralysis or Bell's Palsy (paralysis of the seventh cranial nerve or 'facial nerve') occurs in both sexes equally and at all ages, though it is commonest in early adult life. It comes on rapidly, generally after exposure to wet or cold, or to draughts on the side of the face. An exactly similar type of facial paralysis may occur in cases of acute inflammation of the middle ear, or after operations on the mastoid. The onset is usually sudden, and the paralysis is generally complete from the first. If it is incomplete, the lower part of the face is more affected than the upper. The first symptom is that the patient feels one side of the face to be stiff when he attempts to move it. The paralysed side of the face shows a striking contrast with the normal side. It is smooth and free from wrinkles, and devoid of any form of expression, so that the patient cannot laugh or weep or frown or express any feeling or emotion, while the features of the normal side are in fullplay. The eye cannot be closed because of the drooping of the lower eyelid, and the mouth cannot be moved on the affected side so as to expose the teeth. Speaking becomes difficult, and fluids may escape from the mouth on drinking, and saliva dribbles away. The duration of the paralysis varies within wide limits. Quite slight cases may recover in ten to fourteen days. Others remain unaltered for many weeks or months, but recovery always occurs finally, and as a rule within two years. The recovery always appears first in the upper part of the face. In cases associated with some underlying disease of the brain or bones of the ear, recovery may be uncertain.
Research Bell's Paralysis