Patients come in complaining of drooling and/or “facial swelling”. Unable to use a straw and complaining of dry eyes, they may not be able to tighten their lips around the straw or close their eyes. Everything was fine the day before. Angelina Jolie has shared her experience with Vanity Fair Magazine and it is important to understand her journey and its cause.
Bell’s Palsy is a temporary condition in which the facial nerve or it’s covering/insulation (myelin sheath) becomes swollen. The facial nerve controls the ability to close the eye and have facial expressions. If disrupted, it can interfere with tear duct glands, salivary glands and taste.
Approximately 40,000 Americans are affected annually. It is a diagnosis based on clinical findings and does not require imaging or electrical nerve testing. Generally occurring in a wide age gap of 15-60 years of age, I had a recent case with a 7-year old. Thankfully, this child and most patients recover completely.
Many patients with Bell’s Palsy describe a recent respiratory or gastrointestinal infection. Most studies indicate its cause is due to a viral infection such as the herpes simplex virus (often responsible for the common cold).
The earlier we can begin steroids and anti-virals (such as valcyclovir), the more quickly we gain ground in recovery. Often, we will recommend lubricating eye drops such as artificial tears along with eye patches if there is significant eye irritation due to lack of blinking-ability. Nerve decompression surgery is rarely required. Some physical therapist will use nerve stimulation to improve outcomes and more quickly bring about healing. Discuss all treatment options with your medical provider.
It would be rare that the paralyzing symptoms do not completely resolve or that Bell’s Palsy recurs on the same side or opposite side of the face. I have seen this happen in a few patients and overall outcome were positive. Based on Angelina Jolie’s pictures, she seems to have had a full recovery and that is good news. I wish her well in her continued recovery.