Historical perspectives of facial palsy: Before and after Sir Charles Bell to facial emotional expression

Introductory Chapter: Bell’s Palsy

“…However, Cornelis Stalpart van der Wiel in 1683 first clearly observed and recorded a case that was later described as Bell's palsy. Sir Charles Bell (1774-1842), Scottish surgeon anatomist, and First Professor of Anatomy and Surgery at the Royal College of Surgeons, London, is credited with the first authentic description of the anatomy of the facial nerve and its association with the idiopathic peripheral facial palsy in 1821 [2].…”

“…Perhaps the most difficult and poorly understood component of facial palsy is the distinction between voluntary and emotionally driven facial expressions. It must be appreciated that human facial emotional expression is a complex phenomenon resulting from the summation of activity of a large-scale neural network in the cerebral cortex [2]. Gower's description provides an early description of a clinical dissociation between voluntary and emotionally driven facial expressions [3,4].…”

Early Observations on Facial Palsy

“…At last their voluntary action returned by degrees and after electricity had been used for a month, volition had regained its full energy, and the face its natural appearance. (Friedreich, 1798, as cited by Bird, 1979Pearce, 1999) The report in 1704 of James Douglas F. R. S. (1675-1742), a Scottish anatomist and Physician Extraordinary to Queen Caroline (Shelley, 2013) and the Dutch physician, Cornelis Stalpart van der Wiel also preceded Bell (van de Graaf and Nicolai, 2005). In 1804/1805 Evert Jan Thomassen à Thuessink (1762-1832) published an extensive study on idiopathic peripheral facial paralysis (Thomassen à Thuessink, 1804) that he related to trigeminal neuralgia and attributed to rheumatism.…”

“…Such was his fame that Caliph al Moktafi asked him to build the largest hospital in Baghdad. In his work, Kitab al-hawi, is a chapter entitled "Facial Distortion, Spasm and Paralysis," cited by Shelley (2013). Al-Hawi was written for the ruler Manūr ibn Is aq and became known in the West after Gerard of Cremona's twelfth-century Latin translation.…”