Bell's Palsy: A Review

Abstract

Bell's palsy, also known as "acute facial palsy of unknown cause", is a common cranial neuropathy leading to facial muscle paresis or complete paralysis characteristically on one side, occurring suddenly and may progress over 48 hours. It results from facial nerve dysfunction due to trauma or inflammation of the 7 th cranial nerve or facial nerve or its branches along its course, primarily in the bony canal. Both sexes are equally affected, and though no age is immune, its incidence rises with increasing age. The risk is high in diabetics, hypertensives, women who are pregnant, obese, and people with upper respiratory tract infections. It is considered chiefly idiopathic and is diagnosed by the exclusion of other causes. Bell's palsy can cause physical and psychological complications and negatively impact patients and their relatives. Thus, early diagnosis and quick cause determination are prime roles in proper treatment. However, the exact etiology of Bell's palsy is unknown, affecting its treatment. Still, determining probable causative and risk factors is critical for employing a targeted treatment approach and requires a comprehensive examination and a complete history. Although the majority of patients recover spontaneously in less than three weeks even if they are not treated. But there is always a risk of residual paresis after treatment or recovery, which may require medical help. This review aims to furnish the most thorough understanding of Bell's palsy, focusing on anatomy, etiology, clinical features, diagnosis, clinical consequences, and preferred therapy approaches.

Diabetes Mellitus and Acute Facial Palsy: A Nationwide Population-Based Study

“…Age was also a significant risk factor for BP. As shown in Table 2, both in the DM and non-DM cohorts, those aged over 50 showed a higher IR of BP compared to those under 50, which is consistent with previous findings that the incidence increases with age [27]. The prevalence of comorbidities increases with age, which may explain the effect of age on the results of this study.…”

Is There a Relationship Between Bell’s Palsy and White Matter Lesions?

“…Idiopathic peripheral facial nerve paralysis has been designated as Bell’s palsy (BP). BP’s exact etiologic factors are still not clear, although atherosclerosis, viruses, microvascular injury, and neural ischemia have been implicated [ 1 , 2 ]. The ischemia hypothesis claims that microvascular damage, a coagulation disorder, or a vasospasm involving the vasa nervorum of the facial nerve results in BP [ 3 ].…”

“…Viral infections could lead to inflammation and could subsequently result in atherosclerosis [ 4 ]. Various diagnostic tests have been used in the assessment of BP, and magnetic resonance imaging (MRI) is widely used for the assessment of pathology involving the facial nerve, as well as for differential diagnosis [ 1 , 5 – 7 ].…”

Bilateral facial palsy caused by HIV infection: A case report and literature review

“…[2] Facial palsy, also known as "Bell palsy," is a common cranial neuropathy that can lead to paralysis of the facial muscles or complete paralysis on 1 side. [3] The onset is sudden, and the duration of the disease can exceed 48 hours. It is primarily considered idiopathic and is diagnosed when other causes are excluded.…”

“…It is primarily considered idiopathic and is diagnosed when other causes are excluded. [3] BFP is extremely rare, accounting for only 0.3 to 2.0% of facial paralysis cases. [4] Unlike unilateral facial palsy, it is usually caused by a serious systemic disease and, therefore, requires urgent medical intervention.…”