Dr. Ameen, ENT Specialist in Kuala Lumpur

Ever woken up to find one side of your face isn’t moving quite right? It can be alarming, but it might be Bell’s Palsy, a common condition affecting the facial nerve. It’s crucial to understand the condition and how doctors classify its severity. Let’s break it down.

What is Bell’s Palsy? 🤷‍♀️
Bell’s Palsy is a sudden, temporary weakness or paralysis of the muscles on one side of the face. It happens when the facial nerve (the 7th cranial nerve) becomes inflamed or compressed, disrupting its ability to send signals to your facial muscles. While it can be frightening, most people make a full recovery.

Signs & Symptoms 😮‍💨
Symptoms usually appear suddenly and worsen over 48-72 hours.

• Drooping on one side of the face.
• Difficulty closing one eye, leading to dryness.
• Trouble smiling, frowning, or raising an eyebrow.
• Drooling from one side of the mouth.
• Loss of taste on the front of the tongue.
• Pain around the ear or jaw on the affected side.
• Increased sensitivity to sound in one ear.

If you experience these, seek medical attention immediately to rule out other, more serious conditions.

Who’s at Risk? 📉
While anyone can get Bell’s Palsy, certain factors increase your risk:
– Pregnancy, especially in the third trimester.
– Diabetes.
– Upper respiratory infections (like the flu or a cold).
– Family history of Bell’s Palsy.
– Conditions like Lyme disease, herpes simplex virus, or shingles.

Diagnosis & Investigations 🩺
Diagnosing Bell’s Palsy is often a process of exclusion. Your doctor will perform a physical examination to check your facial muscles and assess the severity of the weakness using a standardized tool:

1) The House-Brackmann Facial Nerve Grading System

This is the widely accepted system used by ENT consultants to objectively grade the function of the facial nerve from Grade I (Normal) to Grade VI (Total Paralysis). This grading is important for tracking recovery and determining the best treatment approach.

Grade Description:
I – Normal facial function in all areas.
II – Slight dysfunction (mild weakness, complete eye closure with minimum effort).
III – Moderate dysfunction (obvious but not disfiguring weakness, complete eye closure with effort).
IV – Moderately severe dysfunction (obvious weakness and/or disfiguring asymmetry, incomplete eye closure).
V – Severe dysfunction (only barely perceptible motion, asymmetry at rest).
VI – Total paralysis (no movement).

2) Electromyography (EMG): To measure electrical activity in muscles and nerve response.

3) MRI or CT scan: To rule out other causes like a tumor or stroke, especially if symptoms are atypical.

Treatment Options 💊
Treatment aims to speed up recovery and prevent complications:

1- Corticosteroids (e.g., Prednisolone): Often prescribed within 72 hours of symptom onset to reduce inflammation and swelling of the facial nerve.
2- Antiviral medications (e.g., Acyclovir): Sometimes used in conjunction with corticosteroids, especially if a viral cause is suspected.
3- Methylcobalamin: an activated form of vitamin B12, improves nerve function by helping to regenerate damaged nerves and protect nerve cells. 
4- Physical Therapy: Facial exercises can help maintain muscle tone and prevent permanent contractures.
5- Eye Care: Essential due to the inability to close the eye. This includes lubricating eye drops, ointments, and eye patches to prevent corneal damage.
6- Surgical decompression: Rarely considered, and only in severe, specific cases where other treatments fail.

At-Home Care & Prevention 🏡
While you can’t always prevent Bell’s Palsy, these tips can help manage symptoms and aid recovery:
1) Protect your eye: Use artificial tears during the day, eye ointment at night, and an eye patch to prevent dryness and damage.

2) Facial massage: Gently massage your facial muscles to promote blood flow and ease stiffness.

3) Warm compress: A warm, moist cloth on your face can help ease pain and discomfort.
4) Chew carefully: Eat on the unaffected side to avoid food getting trapped.
5) Manage stress: Stress can weaken the immune system; practice relaxation techniques.

Ready to see me? Click here for Sunway Velocity Medical Centre or here for Columbia Setapak Hospital! Or, if you prefer the old-school way, give a ring at 03-41313771 to book your appointment at Klinik ANDA Wangsa Melawati. Can’t wait to see you!