Bell's Palsy: 10 Terms to Know

Bell’s palsy is a type of facial paralysis, suspected to be caused by a response to a viral infection. The facial nerve becomes inflamed, with symptoms arising as quickly as over the course of a few hours. Treatments are geared at relieving symptoms, as the condition largely heals on its own after a few months. It can still be a frightening occurrence at first though! Here’s a few basic terms to understanding Bell’s palsy.

1. Facial nerve: Also referred to as the 7th cranial nerve (CN-VII), the facial nerve originates in the brain stem. It passes through the stylomastoid foramen, parotid gland, fallopian canal, and then becomes 7,000 nerve fibers that go all over the face. So, although most information refers to the facial nerve, not nerves, this one nerve covers many parts of the face. 
2. Fallopian canal: The fallopian canal is a small passageway within the skull that the facial nerve goes through. The reaction to viruses (like the herpes complex or chickenpox) suspected to be responsible for Bell’s palsy occurs as an inflammation of the nerve inside the fallopian canal. The pressure of the bone on the nerve compresses it and leads to dysfunction of all the facial nerve’s many responsibilities. 
3. Parotid gland: The parotid gland is one of the three major pairs of salivary glands responsible for producing spit. Located in front of the ear on the insides of the cheeks, it is from this that the many branches of the facial nerve emerge. Because the facial nerve is so closely associated with the parotid gland, one of the symptoms of Bell’s palsy is a change in the production of saliva, through drooling or dry mouth. 
4. Lacrimal gland:  The facial nerve is also responsible for carrying signals to the tear glands. Because Bell’s palsy can not only interrupt these signals but also make it difficult to blink properly or shut the affected eye, keeping the afflicted eye moisturized to prevent damage is important. 
5. Stapes: The stapes is a roughly horseshoe shaped ear bone—one of three bones referred to as the ossicles. It passes the vibration of sound on to the inner ear, where it becomes data for the brain to process. The facial nerve is also responsible to the stapes; as such, another symptom of Bell’s palsy can be an over-sensitization to sound. 
6. Electromyography: Electromyography is one of the tests that can be used to ensure that the problem present is in fact Bell’s Palsy and not something more serious, like a stroke. It measures nerve damage by seeing how well signals are being sent and how much a muscle responds to the signals. 
7. Imaging tests: There are many types of imaging tests, but the ones generally most appropriate for Bell’s palsy are computerized tomography (CT) scans and magnetic resonance imaging (MRI). CT scans allow a cross-sectional view of the interior soft tissues of the body, while MRIs produce a very detailed picture for analysis. Either of these can be helpful in determining underlying complications that may not be obvious from a physical exam. 
8. Synkinesis: Aside from eye damage, one of the biggest concerns regarding complications of Bell’s palsy is synkinesis. When the nerve fibers begin to resume their job, they may have grown incorrectly. As a result, a voluntary movement can cause an involuntary reaction because different muscles contract, after “misdirected regrowth." 
9. Prednisone: Prednisone is one of the more popular corticosteroids often used to help with the swelling and inflammation that causes Bell’s palsy. Reduced swelling allows the nerve to fit properly within the fallopian canal again. It’s best to start prednisone injections as swiftly as possible. 
10. Decompression surgery: Decompression surgery used to be used to relieve pressure on nerves, like the facial nerve in the case of Bell’s palsy. However, it has grown out of practice as the risks became higher than the benefits.