Having Bells Palsy

Bell's palsy is a distressing facial palsy condition in which the C7 cranial nerve is inflamed or otherwise blocked, causing half of the face to be paralyzed, appearing not unlike the face of a stroke victim. Only recently have some of the causes of Bell's alsy been identified, but it's still one of those diseases you identify when everything else is ruled out.

This little-known disorder affects one in every 65 people during the course of their lives. Those especially prone to it are diabetics, pregnant women, and young adults. Because two of the causes of this face paralysis seem to be herpes virus (all of them, from the sexually transmitted one to chickenpox virus) and Lyme disease, people with these infections are also very prone.

I didn't have any of these (except youth), yet I still got Bell's palsy.

How I Got Bell's Palsy

It started with violence. As I waited at a bus stop on a rainy morning, a homeless man was taking shelter nearby. I felt sorry for him - first mistake - and offered him my umbrella. What I didn't know was that he was also crazy and hated women. I was very surprised indeed when he attacked me. He punched me in the forehead, then started chasing me with my own umbrella when someone called from across the street, interrupting him.

I ran to a nearby bank and called the police, went on to work with the next bus, and wallowed in the sympathy of my co-workers and students as a massive bruise rose on my forehead. I noticed also, with a little relief, that my sinus infection was subsiding. In retrospect, it was more likely migrating!

A couple of days later, I was riding with my mother and noticed my tongue was numb. "Have you been eating celery?" she asked. (I'm allergic to celery.) I didn't remember any, but discounted the numbness as something I needed to watch but not worry about.

The next morning I woke up, showered, dressed, and got ready to put on my makeup - and stopped dead. Though I hadn't noticed anything up til that point, my massive bruise had been joined by a sagging cheek, lip, and eye. The entire left side of my face looked as if someone had let the air out of it. I screamed. Then I called work, let them know I'd be late, and made an appointment at a local medical clinic.

The Course of Bell's Palsy

Researchers believe Bell's palsy is caused by viral infections - herpes, Lyme disease virus, and probably other viruses and germs. The facial paralysis we see is actually the symptom of an inflamed or broken facial nerve, and it won't go away until the inflammation is gone or the nerves have regenerated, depending on the root cause.

Unfortunately, facial palsy is also caused by a variety of other disorders - stroke, meningitis, diabetes, tumors, and head trauma. In my case, our working theory was that because I had a sinus infection at the time I was hit, the bacteria were able to escape my sinuses and enter my forehead, where they traveled back along the nerve to infect it at the root. One quick way to determine whether it's probably Bell's Palsy is to try to wrinkle your forehead. If you can't wrinkle the paralyzed side, it's probably Bell's palsy.

Currently, researchers think about 70% of Bell's palsy cases can be cured with antiviral medications like acyclovir or some antibiotics. When the patient first presents, the doctor should also consider using prednisone or another corticosteroid to combat the inflammation before the nerve is damaged beyond repair. If your doctor just throws his hands up and says to wait it out (mine did), start asking questions. No action may be the correct action - but if you can't close your eye or mouth, a corticosteroid could help you in the short term.

In most people, Bell's palsy runs its course in a couple of weeks. Many, however, are affected over the long term, and if the nerve is damaged by the inflammation, the facial paralysis could be permanent.

The End of My Bell's Palsy

In the end, though it was a frightening thing to see every morning in the window, my Bell's palsy improved all by itself, perhaps helped along with the Tylenol I was already taking for headache. After the first couple of days, my co-workers stopped commenting on it. I had fun on the day I was in a car accident; seeing my face gave the EMT workers a great scare! But one day, I noticed I could actually close my mouth when I chewed. A couple of days later, my face was nearly back to normal, by itself. Today, several years later, I don't seem to have any residual effects at all.

I was lucky. About 15% of Bell's palsy patients do have some permanent damage, usually minor, but sometimes not. When nerves regrow, if they hit the wrong place they can cause synkinesis, where one facial movement triggers a different one (winking causes your lip to curl, for instance). Others have crocodile tear syndrome, where they cry while eating because the salivary glands and tear ducts are using the same nerve. Others may lose part or all of their sense of taste, or be unable to completely close their eyes.

Still, whatever small residual effects are left by Bell's, the relief when it is gone cannot be described. I was thrilled to have my normal face back again.