Bell’s Palsy is what most people would look at as a type of paralysis or weakness in the face. In fact, it’s a very specific kind that has an acute onset – meaning it happens rapidly, it happens to one side of the face and it’s not one of the types of paralysis that you would really see from birth or anything else like that. In those cases, it’s called facial paralysis or it’s part of a different syndrome. It’s not actually called Bell’s Palsy, which came from Charles Bell who tried to initially name or describe the syndrome. Bell’s Palsy happens to probably 1% of the population (or so) at some point in their life. Sometimes it’s so mild that you wouldn’t notice it. Sometimes it’s so severe and debilitating that you’d have a complete inability to move the face. We’ve come up with a rating scale to describe the severity and it’s from 1-6. This grading scale allows the physician not only to diagnose the type of Bell’s Palsy or the severity of it, but also give a prognosis or outcome to the patient. In general, you would assume that if Bell’s Palsy is not treated, you would still have a fairly good outcome and the majority of patients. 85% or so who develop a mild or moderate Bell’s Palsy will resolve on their own within the first 3 weeks. Beyond that, you have the patients with more severe Bell’s Palsy or more severe paralysis and they tend to have a poorer prognosis. The question is: what do you do about it to increase your chances of healing from Bell’s Palsy? Number one is: you go and see the doctor right away. Any emergency room doctor can handle this. The treatment that we know now is to use very, very strong corticosteroids. Corticosteroids are different than the type of steroids that you would take for exercising. These are steroids that decrease the effect of your immune system in your body. The current course of treatment that ranges from person to person or doctor to doctor, but it’s generally 1-2 weeks of a high dose tapered corticosteroid. Previously, we thought that the syndrome was caused by a virus in the herpes family and we gave shingles-type medications like Valtrex, Valcyclovir, Acyclovir. Several studies have been done since that time showing that it has no benefit, however many physicians still prefer to give it because of the low chance of any side effects. What you need to determine, though, is: am I having Bell’s Palsy, if anything ever happens? Stroke can give a similar appearance with really, really subtle differences. There’s other syndromes called Ramsay Hunt Syndrome that do happen from the same type of herpes viruses and there are a whole host of other things that can cause it. So in general, the best thing is to see a doctor immediately and seek treatment immediately. The people who get treated immediately, they tend to respond much, much better than other patients.
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