Bell's Palsy, Definition, Symptoms, Causes, Diagnosis, Treatment, Prevention, Complications

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Bell's Palsy, Definition, Symptoms, Causes, Diagnosis, Treatment, Prevention, Complications

Bell's palsy is paralysis on one side of the facial muscles so that one side of the face appears to sag. Bell's palsy occurs suddenly, but is usually not permanent. Bell's palsy can happen to anyone. However, this condition is most common in pregnant women, diabetics, and people with upper respiratory infections, such as the flu.

Many people think of Bell's palsy as a stroke because they both cause symptoms of paralysis. In fact, the symptoms of Bell's palsy are limited to the facial muscles and most sufferers can recover completely within 6 months.

Although both cause partial facial paralysis, Bell's palsy is different from Ramsay-Hunt syndrome. This syndrome is a complication of herpes zoster which attacks the facial nerve.

Causes and Symptoms of Bell's Palsy

Bell's palsy results from inflammation of the nerves that control the facial muscles. The condition is thought to be linked to viral infections, middle ear infections, and Lyme disease.

Bell's palsy is characterized by paralysis on one side of the face. These complaints can be seen from changes in the shape of the face so that sufferers find it difficult to smile symmetrically. In addition, sufferers may also experience other symptoms, such as watery eyes and drooling.

Bell's Palsy Treatment and Prevention

People with Bell's palsy who have mild symptoms usually don't need treatment. While patients who experience severe symptoms can undergo self-care, as well as treatment with drugs, physiotherapy, or surgery.

Bell's palsy cannot be prevented. However, the risk of developing Bell's palsy can be reduced by controlling the diseases associated with this condition and avoiding exposure to cold air.

Causes of Bell's Palsy

Bell's palsy occurs when the nerves that control facial muscles become inflamed. The inflammation causes the muscles to be compressed partially or completely so that the muscles connected to the nerves also stop working. This condition makes facial muscles paralyzed.

The exact cause of neuroinflammation is not known. However, this condition is thought to occur due to viral infections, such as:

Herpes simplex virus
varicella zoster virus
Cytomegalovirus

In addition to viral infections, there are several other diseases that are thought to trigger Bell's Palsy, namely middle ear infections, sarcoidosis, tumors in the salivary glands, hypertension (high blood pressure), or diabetes.

Bell's Palsy Risk Factors

Bell's palsy can happen to anyone. However, there are a number of factors that can increase a person's risk of developing this condition, namely:

15–60 years old
Suffering from an autoimmune disease, such as myasthenia gravis
Are pregnant, especially in the third trimester
Suffering from an upper respiratory tract infection (ARI), such as the flu
Having a family member with Bell's palsy
Suffering from obesity
Suffering from a viral infection, such as COVID-19
Getting vaccinated for COVID-19
Suffering from diabetes
Suffering from high blood pressure
Suffering from dyslipidemia, which is a condition when the level of fat in the blood increases
Exposed to cold air
Exposure to radiation
Have severe preeclampsia

Symptoms of Bell's Palsy

Gejala Bell’s palsy dapat bervariasi pada setiap orang dan dapat bersifat ringan atau berat. Gejala Bell’s palsy juga datang secara tiba-tiba.

Tanda paling umum pada penderita Bell’s palsy adalah kelumpuhan di salah satu sisi wajah yang muncul secara mendadak. Kelumpuhan ini dapat berlangsung dalam 2 minggu hingga 6 bulan dan biasanya tidak permanen. Pada kasus yang jarang terjadi, kelumpuhan dapat terjadi di kedua sisi wajah.

Kelumpuhan wajah ini akan tampak dalam:

Perubahan bentuk wajah
Salah satu sisi wajah tampak melorot
Sulit tersenyum
Sulit menutup mata

Selain perubahan bentuk wajah, gejala lain juga dapat dirasakan oleh penderita, yaitu:

Rasa nyeri di sekitar rahang dan belakang telinga pada sisi yang mengalami kelumpuhan
Sakit kepala
Penurunan kemampuan mengecap rasa
Mata kering
Otot wajah berkedut
Air liur yang menetes (mengiler)
Telinga berdenging atau tinnitus
Sensitif terhadap suara

Kapan Harus ke Dokter

Segera ke dokter jika Anda mengalami kelumpuhan di wajah. Hal ini untuk mewaspadai terjadinya stroke, karena stroke dan Bell’s palsy sama-sama menunjukkan kelumpuhan pada satu sisi wajah. Meski begitu, stroke juga dapat mengakibatkan kelumpuhan pada bagian tubuh lain.

Pemeriksaan sejak dini juga diperlukan karena pengobatan Bell’s palsy bisa lebih efektif jika dilakukan dalam 3 hari sejak munculnya gejala.

Diagnosis Bell's Palsy

To diagnose Bell's palsy, the doctor will ask questions about the symptoms experienced by the patient, including when the symptoms appeared in the patient. After that, the doctor will perform a physical examination of the patient's facial condition.

The doctor will ask the patient to perform some movements, such as closing the eyes, raising the eyebrows, or frowning to detect facial nerve palsy.

To determine the cause, the doctor may also perform several follow-up examinations, such as:

Electromyography (EMG), to detect nerve damage
MRI and CT scan, to make sure there are no abnormalities in the brain
Blood tests, to determine the presence of other diseases that trigger Bell's palsy, such as diabetes or Lyme disease

Bell's Palsy Treatment

Treatment for Bell's palsy depends on its severity. Patients who experience mild symptoms usually do not need special treatment. Meanwhile, in patients with severe symptoms, treatment will be carried out to speed up the healing process and prevent complications.

Some methods of treating Bell's palsy that can be done are:

Drugs

The following are drugs that are usually given for the treatment of Bell's palsy:

Corticosteroid drugs
Corticosteroids are given to relieve inflammation of the facial nerve. This medication is more effective if given when symptoms have been present for a few days. An example of a corticosteroid drug is methylprednisolone.
Antiviral drugs
Antiviral drugs are given to treat Bell's palsy due to a viral infection. These drugs are usually combined with corticosteroids. Examples of antiviral drugs are acyclovir and valacyclovir.
Pain reliever
This drug is given to relieve pain that appears. Examples of pain relievers are paracetamol and ibuprofen.

Therapy and Action

Patients with mild symptoms generally require a recovery time of 2 weeks to 6 months. However, in some cases, the healing process can take longer.

To speed up the return of facial nerve and muscle function, there are several other treatments that can be done, such as physiotherapy.

In addition, doctors can also give Botox injections if the patient experiences tension in one of the facial muscles. Botox will be injected directly into the tense muscle.

Operation

Although rare, surgery can be performed to correct long-term problems with the facial nerve. Surgery can return the face to its normal and more symmetrical position.

Self Care

In addition to being treated with some of the methods above, patients can perform several self-care treatments to speed up the healing process and prevent complications, namely:

Use eye drops during the day.
Use eye ointment at night.
Use adhesive or blindfold while sleeping.
Use eye protection or goggles.
Drink through a straw so the water doesn't drip.
Enough rest.

Complications of Bell's Palsy

Patients with Bell's palsy who receive treatment generally do not experience complications. However, severe Bell's palsy can cause the following complications:

Permanent damage to the facial nerve
Involuntary muscle movements
Partial or complete loss of vision
Injuries to the cornea of the eye (corneal ulcers)
Loss of ability to taste
Speech disorders

Bell's Palsy Prevention

Bell's palsy cannot be prevented. However, you can lower your risk of developing this condition by taking the following steps:

Controlling diseases that can cause Bell's palsy, such as diabetes and hypertension
Avoid excessive exposure to cold air
Lose weight or maintain ideal body weight

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