Bell's palsy is a disorder of the nerve that controls movement of the muscles in the face. You may need to wear an eye patch while you sleep. Sometimes medicines may be used, but it is not clear how much they help. Doctors give trusted, helpful answers on causes, diagnosis, symptoms, treatment, and more: Dr. Wachsman on bell s palsy eye patch: Resolve on its own completely. The time table is different for everyone. If you have Bell's Palsy, it is advisable to wear a patch and/or tape over your eye at night while you sleep to protect your eye from potential damage (drying out as well as poking accidents). This video shows you. Bell Palsy Treatment & Management. It is universally accepted that eye care is imperative in Bell palsy. Care must be taken to prevent worsening the abrasion with the tape or patch by ensuring that the. It affects between 2. UK means between 1. It has not yet been possible to find out why the facial nerve becomes compressed; however, links have been made with viruses (including herpes, influenza and respiratory tract infections), as well as a depleted immune system and stress. Although no certain cause has been established, sufferers of Bell’s palsy should understand that they are unwell. It is important to get plenty of rest even if they have no other symptoms and to maintain a healthy diet. If you are at work or school, it may be necessary to take some time to recover. What are the symptoms of Bell’s palsy? Bell's palsy often comes on suddenly, without warning, over a number of hours, peaking at 7. In eight out of ten cases, it will slowly disappear over a period of weeks or months. Having Bell's palsy can be a frightening and confusing time and a person with Bell’s palsy may initially fear that they are having a stroke. Also, in Bell’s palsy there is no weakness of the hands, arms or legs. Conversely, sometimes, the inability to close the eye properly can result in the eye watering. Difficulty with eating, due to loss of control of the lips and mouth on one side; food may get trapped in some areas as a result, and there may be involuntary drooling. Difficulty with speaking clearly, particularly with pronouncing particular sounds and letters, such as . He/she will ask you to perform a range of facial movements, such as closing your eye, puckering your lips, raising your eyebrows and smiling. A diagnosis of Bell’s palsy is likely if you have rapidly lost the ability to move the affected side of your face at all, or your facial movement is severely impaired and you have no other symptoms or signs. To eliminate any other potential causes, your doctor may also request that you undergo: Blood tests to rule out other potential causes, such as Lyme disease and Ramsay Hunt syndrome. Imaging, such as magnetic resonance imaging (MRI) and computerised tomography (CT scan), to rule out other potential causes such as tumours. Tests with an Ear, Nose and Throat (ENT) specialist. A nerve test called electromyography (EMG) may be requested sometime after the onset of facial paralysis to identify if the facial nerve has been damaged, and if so, how much damage has taken place. The two main treatments to help reduce inflammation and therefore relieve pressure on the facial nerve are steroids and antiviral drugs, although the latter are normally only used for patients with Ramsay Hunt syndrome. Steroids and antiviral medication need to be given within 7. Please note that after 7. Aciclovir is the antiviral drug which is often prescribed for the initial treatment of facial palsy where it is suspected that Ramsay Hunt syndrome (a viral infection) is responsible, for example due to the presence of a rash on the ear of the affected side. Bell's Palsy Eye Patch. The only eye patch created specifically for patients of Bell's Palsy. The PalsyPatch Eliminates.Your doctor or pharmacist will be able to prescribe/supply you with artificial tears, to ensure that your cornea is kept moist and protected. This is because there is evidence to suggest that exercising of this nature can encourage the development of synkinesis (miswiring of nerves; see . Improvement can occur as early as two to three weeks from onset; however, a full recovery can take anywhere from three to six months and beyond. In the remaining 2. Severe nerve damage is more likely to occur if the patient. Is over 6. 0; Had severe pain at onset; Had complete rather than partial paralysis at onset; Had a preexisting health condition such as diabetes or high blood pressure; Was pregnant at the time of onset; If recovery had not begun after six weeks. Newer and more advanced treatments are able to assist people with severe nerve damage with managing their condition, in terms of expressiveness, facial function and appearance. Seven per cent of patients have recurrent Bell's palsy, with the average interval between attacks being ten years. What are the possible complications of Bell’s palsy? Due to the complexity of our facial muscles and their function, a number of problems can arise following the prolonged experience of having Bell’s palsy: Contracture: Shortening of the facial muscles over time may make the affected side of the face appear to be slightly 'lifted' in comparison to the unaffected side, and the affected eye may appear smaller than the unaffected eye. The fold between the outer edge of the nostril and the corner of the mouth may seem deeper due to the increased contraction of cheek muscles on that side. Crocodile tears: This means that the affected eye waters involuntarily, particularly whilst eating. This is due to faulty 're- wiring' of the nerves during the recovery phase. Lagophthalmos: This is an inability to close the affected eye, which if prolonged may result in eye dryness and/or corneal ulceration. For example, on smiling the eye on the affected side automatically closes. Similarly, on raising the eyebrows or closing the eyes, involuntary contraction of the cheek or neck muscles occurs. People with persistent symptoms of Bell’s palsy may experience psychological problems including stress, anxiety, depression and low self- esteem. Discovering that you have Bell's palsy can be a frightening time, and we hope that our website can provide you with lots of useful information, tips and advice as well as reassurance in discovering you are not alone. Your GP will be able to discuss the physical impact of your condition with you and refer you on to facial palsy specialists such as physiotherapists, speech and language therapists and facial palsy clinics. Bell's palsy - Treatment - NHS Choices. Prednisolone is recommended as the most effective treatment for Bell’s palsy, and it should be started within 7. Most people recover fully from Bell's palsy within nine months, but it's important to maintain good eye care during this time. Antiviral medications are not recommended as a treatment for Bell's palsy. Prednisolone. Prednisolone is a corticosteroid which works by helping to reduce inflammation (swelling), helping to speed up your recovery. People with Bell's palsy are usually advised to take prednisolone tablets twice a day for 1. Possible side effects of prednisolone include: nausea (feeling sick) headache increased sweating indigestion increased appetite difficulty sleeping oral thrushdizziness These side effects should improve within a few days as your body begins to get used to the medication. Some people also experience mood changes, such as anxiety or depression, after taking steroids for a short period of time. You should visit your GP immediately if you experience mood changes, or if you have other side effects that are particularly troublesome. Read more about the side effects of corticosteroids. Speak to your GP before taking prednisolone if you are pregnant or breastfeeding. Eye care. Tears play an important role in protecting your eyes and keeping them free of the dirt and bacteria that can cause eye infections. If you have Bell’s palsy, you might find it difficult to close your eye, which can cause your tears to evaporate and leave your eye vulnerable to infection. So it's very important to keep your eye lubricated. Your GP may prescribe eye drops that contain 'artificial tears' for daytime use, plus an ointment that you should use at night. If you're unable to shut your eye at night time, your GP will give you some surgical tape to close your eye. If your eye symptoms get worse, you should ask your GP to refer you to the facial palsy clinic or ophthalmology department of your local hospital for assessment. If ointments and taping are not effective you may benefit from surgery to help protect your eye. Further treatment. Most people with Bell's palsy will make a full recovery within nine months. However, if you have not recovered by this time, there is a risk of more extensive nerve damage and further treatment may be needed. Physiotherapy. Physiotherapy may be recommended. Your physiotherapist will teach you a series of facial exercises that will strengthen the muscles in your face to improve their co- ordination and range of movement. Physiotherapy has been successful in a number of Bell's palsy cases, although it may not be suitable or effective for everyone. Plastic surgery. Plastic surgery is another possible option. Plastic surgeons work as part of a team of facial palsy specialists to help manage your facial weakness. Surgery may not be able to restore nerve function, but may be able to protect your eye, improve your function and improve the appearance of your face. Eye procedures include surgery to help you close your upper eyelid or improve the position of your lower eyelid. A brow lift can improve your vision and facial appearance. A number of procedures can improve the position of your mouth and help with speech, eating and drinking and facial symmetry. Some can restore a smile, including cross- facial nerve grafts, nerve transfers and muscle and tendon transfers. Botulinum toxin injections. Botulinum toxin (Botox) injections can be used to treat either the affected or the unaffected side of the face in some people with long- term Bell's palsy. Botox may be injected into the affected side of the face to relax any facial muscles that have become tight, or to reduce any unwanted muscle movements. If the muscles in the unaffected side have become overactive or dominant, Botox may be injected into this side of the face to reduce muscle activity and balance the movement of the face. Some of the long- term complications of Bell’s palsy can also be treated using Botox injections. These include: tears when eating eye- mouth synkinesias – where the facial nerve grows back in a different way, which can lead to a winking eye when eating, smiling or laughing Read more about the complications of Bell’s palsy. The Botox injections can help ease any discomfort experienced while eating and can also help to improve the overall appearance of the face. The injections need to be repeated every four months. Other treatments. Research has suggested that facial exercises, relaxation techniques and acupuncture may help speed up the recovery of Bell’s palsy and restore facial nerve function. Page last reviewed: 1. Next review due: 1.
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