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Is Bell’s palsy permanent?

Many sources say that if within 1 year you did not recover after your facial palsy, be it Bell’s palsy or Ramsay Hunt Syndrome, you will remain like this forever.

This frustrating information forces many Bell’s palsy sufferers to resort to surgery or other permanent cosmetic alterations and painful therapies. Others may, even, give up and do nothing for many years.

Estimated reading time: 6 minutes

Please note that in this article, we are discussing peripheral facial palsy (such as Bell’s palsy, Ramsay Hunt Syndrome). The recovery and further improvements after mechanical injuries to the facial nerve (after surgery, trauma, etc.) or in some cases of congenital facial palsy may differ from description below. For more details on such cases, please contact us.

After hearing from medical sources, including your doctors, that Bell’s palsy is permanent, it is natural to lose hope. The belief that it is possible to improve naturally, becomes barely existent, considering any promise to restore smile without surgery as a “too good to be true” miracle.

Let us be the bearers of good news, and explain why this common belief is not entirely true.

Bell’s palsy is not permanent.

We had a patient, Atlanta, she was 65 years old when she came to our clinic. She got facial palsy when she was 2.5 years old. So, on the day of her first visit to the clinic, it was over 62 years since her facial palsy.

After her rehabilitation, Atlanta wrote:As a child, I remembered that electric shocks were used to restore the paralysis. If I had to go to the hospital for treatment, I would sit in front of my father’s bike, crying very hard. Eventually, my parents stopped the treatments.

When I got older, I tried acupuncture, but it didn’t really help. I was advised to have surgery, but that was definitely not the solution for me because it was not without risk. I always put my hand over my mouth and didn’t want to be photographed.

By coincidence, I came across the Crystal Touch website and immediately signed up for an information day in November 2014. I directly started the treatment and after the first visit I already saw the result. Now a year later, I’m taking a picture again and smiling without a hand over my mouth.

Portrait of Atlanta
Portrait of Atlanta after her rehabilitation

Does this mean that Atlanta had facial palsy for all this time? Did her Bell’s palsy stop after the rehabilitation? Does she still have it?

To answer these questions, we need to take a look at the processes of facial palsy and facial nerve regeneration.

When Bell’s palsy starts

Facial palsy begins when the facial nerve fully disconnects from its facial muscles (this is called a conduction block).

The facial nerve becomes damaged and unable to conduct electrical signals from the brain to the facial muscles.

This results in paralysis.

When Bell’s palsy ends

The facial nerve will require between a few weeks to a few months to recover and regenerate. Once the level of recovery is sufficient, the facial nerve reconnects with the facial muscles, and you start seeing first movements on the affected side.

At this stage, Bell’s palsy is finished.

Because essentially, facial palsy is a paralysis. When your muscles begin to move, you do not have paralysis any more.

Complications and residuals are not Bell’s palsy

What happens, is that due to the long recovery process, you develop complications and residual effects. Within a year, after your recovery reaches its saturation point, your improvements will become incremental and barely noticeable. At this point, doctors and many other specialists will say that from now on, your Bell’s palsy is permanent.

What most specialists and doctors fail to say, is that this is not facial palsy any longer. These are the results of a long recovery. If the damage was deep, some facial nerve fibres may not recover fully. In addition, your muscles may become tight. You may experience synkinesis and spasms.

It is important to realize, that your face is no longer paralysed, because you have at least some movements. Facial asymmetry and lack of movements may happen due to several reasons, only one of which being an incomplete regeneration of facial nerve fibres.

Take a look at the recording of Synkinetic Correlation Analysis of one of our patients. This recording, taken with a special electronic instrument called an electromyograph, shows the difference in the intensity of contraction signals between the healthy and affected sides that arrive through the facial nerve to the facial muscles involved in a certain facial expression. On the left side, you see the intensity of signals on the healthy side. On the right, their intensity on the affected side. The signals on the affected side are actually stronger than on the healthy side, even if the movements are smaller (you can see the movements on the portrait photo). If the facial nerve, according to popular belief, was still dead, would it be able to conduct such intense signals?

Synkinetic Correlation Analysis
Conductivity of facial nerve on healthy side vs affected after facial palsy.

In our experience, in the vast majority of facial palsy cases, the recovery of facial nerve is sufficient to pass signals and move facial muscles. In these cases, synkinesis and tightness of facial spasms may be the answer why you have facial asymmetry and lack of movements.

Complications are not permanent, if you work on reducing them

So to answer the main question: no, peripheral facial palsy (Bell’s palsy, Ramsay Hunt Syndrome), is not permanent.

Its complications and residual effects may remain permanently, if you do nothing.

Residuals and complications such as synkinesis, tight and painful facial muscles, excessive tearing or dry eyes, spasms, etc., will not go away by themselves. Fortunately, it is possible to reduce them without surgery or painful treatments.

As shows the story of Atlanta and our other patients, it is possible to improve the symmetry of your face, and smile with a happy, genuine smile, again. It takes hard work, but with a strong motivation and professional guidance, you can improve your condition.

We developed the Neuro-Proprioceptive Rehabilitation method with the sole aim to help you recover and reduce manifestations of complications and residuals after peripheral facial palsy (Bell’s palsy and Ramsay Hunt Syndrome included).

We are here to help you and guide you on the journey to bring back your smile. Reach out to us.

Alex Pashov

Alex Pashov

Co-founder of Crystal Touch clinic and Bell's palsy expert.

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