There is a lot of information about Bell’s palsy, both in our Knowledge Base and elsewhere on the internet. It can be challenging to understand what are the most important lessons you can take for yourself from all of that. So, in this article, we would like to summarize five of the most essential details you should remember about Bell’s palsy.
Estimated reading time: 4 minutes
Five essential details about Bell’s palsy:
Please note: although we use the term “Bell’s palsy” in this post, current information is also applicable to all kinds of peripheral facial nerve palsies (including Ramsay Hunt Syndrome).
1. Bell’s palsy is not a disease
From our point of view, it is an acute functional disorder.
Therefore, it should not be regarded as a disease that can be cured mainly through medications and is expected to recover within a relatively short time. It should be regarded as any other functional disorder. It requires time, proper recovery conditions and possible rehabilitation measures afterwards, if complications develop.
2. Bell’s palsy does not last forever
By itself, Bell’s palsy ends as soon as the first facial movements appear. Usually, the acute phase of Bell’s palsy can last from two-three weeks to a couple of months, depending on the severity of the initial damage to the facial nerve. As soon as you notice the first movements reappearing on the affected side, your Bell’s palsy finishes.
What one may suffer from afterwards (for months or years) are complications and residuals that may form after a long-term recovery. These complications usually include synkinesis, chronic pains, facial asymmetry, etc. which can be reduced or in some cases eliminated with certain rehabilitation techniques.
3. Bell’s palsy only affects the facial nerve
If Bell’s palsy was not caused by a traumatic injury or surgery, then only the facial nerve sustains damage. Your facial muscles are not affected.
Bell’s palsy causes damage either to the myelin sheath of a facial nerve, impacting its conducting abilities only, or also to the nerve fibres. In the former case it leads to light damage and quick recovery, and in the latter case the recovery takes more time and might be incomplete or cause complications.
In either case, your facial muscles remain healthy and able to work. The paralysis happens only due to the damage to the nerve.
4. After Bell’s palsy, the atrophy of facial muscles does not occur
Unlike our skeletal muscles, the facial muscles are innervated by two separate nerves: the facial nerve and trigeminal nerve. The facial nerve consists mostly of motor neurons, which transmit movement signals from the brain to the facial muscles. Meanwhile, most of the sensory signals from our facial muscles to the brain are transmitted via the trigeminal nerve.
Bell’s palsy affects only the facial nerve, and does not injure the trigeminal nerve. So even when the movement signals cannot pass from the brain to the muscle, the brain can still “communicate” with the facial muscles through the trigeminal nerve and continues to keep the muscles alive. This sensory “communication” of brain and muscles is required in order to avoid atrophy of muscles that are not moving.
So, instead of atrophy, you may experience a reduction in the tonus of the facial muscles (they appear thinner, flaccid), due to the lack of movements. This will get better when their connection with the facial nerve is re-established.
5. Bell’s palsy does not affect the nucleus (root) of the facial nerve
The nucleus of the facial nerve is located deep within our brain. The damage to the facial nerve during Bell’s palsy most often occurs in the narrow bone channel behind our ear, where the nerve passes from the brain to the face. This damage does not extend further up towards the brain, and the nucleus remains intact.
As the nucleus remains alive and functional, the nerve does not die during Bell’s palsy. That is one of the reasons why it is possible to improve your level of recovery even years after the Bell’s palsy had happened.
There is always hope for improvement
Whether you just got Bell’s palsy, or have been suffering from its residuals and complications for years, there is always hope for improvement. The results of our patients are a proof that it will not stay the way it is. Be patient, hopeful and positive.
We are open to sharing our knowledge and experience with you, answering your questions and helping you to bring back your smile.