Bell’s Palsy

Bell’s palsy is a condition that causes a temporary weakness or paralysis of the muscles on one side of the face. It can occur when the nerve that controls the facial muscles becomes inflamed, swollen, or compressed.

The condition causes one side of your face to droop or becomes stiff. Patients may have difficulty smiling or closing their eye on the affected side. In most cases, Bell’s palsy is temporary, and symptoms usually go away after a few weeks/months.

Although Bell’s palsy can occur at any age, the condition is more common among people between ages 16 and 60.

Bell’s Palsy vs Facial Paralysis

Bell’s palsy and facial paralysis are two different conditions, although some of the symptoms may appear similar.

While facial paralysis may occur for several reasons, including tumours, trauma and salivary gland inflammation, the exact cause of Bell’s palsy is unknown. The condition has been associated with certain viruses such as herpes simplex (HSV) and herpes zoster (shingles). These viruses can lay dormant for years but can suddenly become active in the bone behind the ear, causing the facial nerve to become swollen and rapidly ‘shut down’.

Bell’s palsy typically occurs suddenly and without warning and generally results in immediate facial paralysis.

Symptoms of Bell’s Palsy

The primary symptoms of Bell’s palsy are facial and mouth drooping that affects just one half of the face. Most people with Bell’s palsy are also unable to blink on the affected side of the face

Additional Bell’s palsy symptoms may include:

• Pain in or behind the ear
• Headache
• Numbness of the affected side of the face
• Increased sensitivity to sounds
• Altered taste
• Inability to fully close the eyelids of one eye (often causing dry eye)

In many instances, Bell’s palsy symptoms disappear on their own within three months of an initial diagnosis. However, if Bell’s palsy symptoms linger for eight months or longer, the condition might cause permanent paralysis of one side of the face.

Bell’s Palsy Treatment With Botulinum Toxin Type A

Luckily, many treatment options are available today to help patients to eventually restore the facial muscle function, including injections of Botulinum Toxin Type A.

Botulinum toxin is a protein produced by the bacterium Clostridium botulinum which blocks the electrical impulses that make the facial muscles contract. Sometimes injections may be placed just in the affected side, just in the unaffected side or in both sides.

How Does The Treatment Work

When it comes to Bell’s palsy, the Botulinum Toxin treatment works in two ways:

1. The management of facial synkinesis, a condition that causes involuntary facial movements and often occurs following Bell’s palsy. Common signs of synkinesis include facial twitching, tight facial muscles and facial muscle spasms. Botulinum toxin for synkinesis works by reducing the activity of facial muscles in the forehead and other areas of the unaffected side of the face, allowing the overactive muscles to be completely “retrained” in Bell’s Palsy cases.
2. Restoring symmetry and balance of movement across both sides of the face. When the affected side of the face is weaker, the muscles of the unaffected side have to work harder and get stronger. This can increase the imbalance and asymmetry in the face. Botulinum Toxin injections in specific areas of the unaffected side can restore better balance and enhance a patient’s facial appearance.

Benefits of Botulinum Toxin Injections for Facial Palsy

Botulinum toxin injections represent a minimally invasive technique that is helpful in restoring facial symmetry in chronic, and potentially acute, Bell’s palsy.

Some of the benefits include:

• Great relief from the pain and symptoms
• Restored facial symmetry and overall facial comfort
• The procedure is quick and has no downtime
• Reduced muscle action is noticeable within 12 to 18 hours post-injection with maximum results seen by the end of the first week after treatment
• Topical anaesthetics can be used on sensitive facial areas for more comfortable treatments

Aftercare and Associated Risks

It is very important to carry out any exercises and stretches given to you by your therapist after having your Botox treatment. This will ensure that you get the full benefits of treatment.

As per the risks associated with Botulinum toxic injections, they are minimal and side effects from injections are rare.

Nevertheless, side-effects can occur and these usually develop in a few days. Potential side-effects might include:

• bruising or swelling at the site of the injection
• a slight feeling of nausea or headache
• tiredness or pain in the arms and legs
• temporary drooping of the eyebrow or upper eyelid
• brief visual disturbances (double vision)
• dry mouth/eyes
• skin rash or itching
• breathing difficulties/swallowing difficulties
• muscle wasting

Treatments of Bell’s palsy with Botulinum toxin are available at Dr. Nina Facial Sculpting clinics and subject to previous consultation.