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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