Bell's palsy history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]
Overview
Common symptoms of Bell's palsy include: rapid onset of mild weakness to total paralysis on one side of the face within hours to days, difficulty making facial expressions in one side, such as closing eye, smiling, whistling and frowning, salivation, facial droop, pain around the jaw or ear and numbness in the skin of affected side. Less common symptoms of Bell's palsy include: Altered taste, changes in the amount of tears and saliva and ear problems (increased sensitivity to sound on the affected side, dizziness).
History and Symptoms
- The hallmark of Bell's palsy is unilateral, acute paresis or paralysis of facial movement. A positive history of viral infections, Ischemic mononeuropathy,Diabetes mellitus and Thyroid disorders is suggestive of Bell's palsy.
History
Patients with Bell's palsy may have a positive history of:
- Viral infections:
- Herpes simplex virus reactivation[1]
- Herpes Zoster[2]
- Cytomegalovirus[3]
- Epstein Barr virus[4]
- Rubella virus[5]
- Mumps[6]
- Influenza B[7]
- Coxsackievirus[8]
- Rickettsial infection [9]
- Borrelia burgdorferi[10]
- Acute HIV infection[11]
- Ischemic mononeuropathy[12]
- Diabetes mellitus[13]
- Thyroid disorders[14]
Common Symptoms
Common symptoms of Bell's palsy include:
- Rapid onset of mild weakness to total paralysis on one side of the face within hours to days[15]
- Difficulty making facial expressions in one side, such as closing eye, smiling, whistling and frowning[16][17]
- Salivation[18]
- Facial droop[19]
- Pain around the jaw or ear[20]
- Numbness in the skin of affected side[21][22]
Less Common Symptoms
Less common symptoms of Bell's palsy include:
- Ear problems such as:
- Increased sensitivity to sound on the affected side[21]
- Dizziness[24]
References
- ↑ Furuta Y, Fukuda S, Chida E, Takasu T, Ohtani F, Inuyama Y; et al. (1998). "Reactivation of herpes simplex virus type 1 in patients with Bell's palsy". J Med Virol. 54 (3): 162–6. PMID 9515763.
- ↑ Morrow MJ (2000). "Bell's Palsy and Herpes Zoster Oticus". Curr Treat Options Neurol. 2 (5): 407–416. PMID 11096766.
- ↑ Walters BN, Redman CW (1984). "Bell's palsy and cytomegalovirus mononucleosis in pregnancy". J R Soc Med. 77 (5): 429–30. PMC 1439928. PMID 6327983.
- ↑ Maeda S, Tsuda H, Haruki S, Mitsuto I (1999). "Atypical Epstein-Barr virus infection associated with Gianotti-Crosti syndrome and Bell's palsy". Pediatr Int. 41 (3): 315–7. PMID 10365586.
- ↑ Jamal GA, Al-Husaini A (1983). "Bell's palsy and infection with rubella virus". J Neurol Neurosurg Psychiatry. 46 (7): 678–80. PMC 1027493. PMID 6886708.
- ↑ Kondo K, Kanaya K, Baba S, Yamasoba T (2014). "Mumps, cervical zoster, and facial paralysis: coincidence or association?". Case Rep Otolaryngol. 2014: 289687. doi:10.1155/2014/289687. PMC 3933221. PMID 24653846.
- ↑ Wijnans L, Dodd CN, Weibel D, Sturkenboom M (2017). "Bell's palsy and influenza(H1N1)pdm09 containing vaccines: A self-controlled case series". PLoS One. 12 (5): e0175539. doi:10.1371/journal.pone.0175539. PMC 5414992. PMID 28467420.
- ↑ 8.0 8.1 McFarlin A, Peckler B (2008). "An unusual presentation of Bell's palsy: A case report and review of literature". J Emerg Trauma Shock. 1 (1): 50–2. doi:10.4103/0974-2700.40574. PMC 2700557. PMID 19561942.
- ↑ Bitsori M, Galanakis E, Papadakis CE, Sbyrakis S (2001). "Facial nerve palsy associated with Rickettsia conorii infection". Arch Dis Child. 85 (1): 54–5. PMC 1718833. PMID 11420202.
- ↑ Schmutzhard E, Stanek G (1985). "Borrelia burgdorferi, a possible cause of Bell's palsy?". Clin Neurol Neurosurg. 87 (4): 255–7. PMID 3912092.
- ↑ Brown MM, Thompson A, Goh BT, Forster GE, Swash M (1988). "Bell's palsy and HIV infection". J Neurol Neurosurg Psychiatry. 51 (3): 425–6. PMC 1032872. PMID 3361335.
- ↑ Fahimi J, Navi BB, Kamel H (2014). "Potential misdiagnoses of Bell's palsy in the emergency department". Ann Emerg Med. 63 (4): 428–34. doi:10.1016/j.annemergmed.2013.06.022. PMC 3940662. PMID 23891413.
- ↑ Pecket P, Schattner A (1982). "Concurrent Bell's palsy and diabetes mellitus: a diabetic mononeuropathy?". J Neurol Neurosurg Psychiatry. 45 (7): 652–5. PMC 491483. PMID 7119834.
- ↑ Cox NH, Chew D, Williams JG, Morris AI (1985). "Bell's Palsy associated with hypothyroidism". Br J Clin Pract. 39 (4): 158–9. PMID 4015946.
- ↑ Murthy JM, Saxena AB (2011). "Bell's palsy: Treatment guidelines". Ann Indian Acad Neurol. 14 (Suppl 1): S70–2. doi:10.4103/0972-2327.83092. PMC 3152161. PMID 21847333.
- ↑ Slavkin HC (1999). "The significance of a human smile: observations on Bell's palsy". J Am Dent Assoc. 130 (2): 269–72. PMID 10036851.
- ↑ Ciorba A, Corazzi V, Conz V, Bianchini C, Aimoni C (2015). "Facial nerve paralysis in children". World J Clin Cases. 3 (12): 973–9. doi:10.12998/wjcc.v3.i12.973. PMC 4677084. PMID 26677445.
- ↑ Cirpaciu D, Goanta CM (2014). "Bell's palsy: data from a study of 70 cases". J Med Life. 7 Spec No. 2: 24–8. PMC 4391366. PMID 25870668.
- ↑ Rafii MS (2006). "Case 14: a woman with bilateral Bell's palsy". MedGenMed. 8 (4): 23. PMC 1868343. PMID 17415306.
- ↑ Han DG (2010). "Pain around the ear in Bell's palsy is referred pain of facial nerve origin: the role of nervi nervorum". Med Hypotheses. 74 (2): 235–6. doi:10.1016/j.mehy.2009.06.027. PMID 19932939.
- ↑ 21.0 21.1 Holland NJ, Bernstein JM (2014). "Bell's palsy". BMJ Clin Evid. 2014. PMC 3980711. PMID 24717284.
- ↑ Vanopdenbosch LJ, Verhoeven K, Casselman JW (2005). "Bell's palsy with ipsilateral numbness". J Neurol Neurosurg Psychiatry. 76 (7): 1017–8. doi:10.1136/jnnp.2004.043059. PMC 1739721. PMID 15965217.
- ↑ Holland J, Bernstein J (2011). "Bell's palsy". BMJ Clin Evid. 2011. PMC 3275144. PMID 21375786.
- ↑ Song K, Chang S, Lee J, Shin SA, Lee HY (2018). "Clinical Characteristics of Dizziness Associated with Acute Peripheral Facial Palsy". J Audiol Otol. doi:10.7874/jao.2017.00374. PMID 29656635.
History and Symptoms
Sudden onset, usually over hours, of unilateral facial paralysis (maximal symptoms by 48 hours).
- Eyebrow sagging with inability to close the affected eye.
- Nasolabial fold flattening with mouth drawn to the non affected side.
- Inability to wrinkle forehead (peripheral lesion).
- May be associated with ear pain, impaired taste sensation on the anterior two-thirds of the tongue, decreased tearing, and hyperacusis.