Bell's Palsy or Facial Nerve Paralysis

A 34 year old Male,sales clerk, came to the clinic complaining of difficulty closing his right eye for 3 days prior to consultation. The symptom just appeared after waking up and he also noted that his smile and the lines in his forehead appears "uneven". He also said that his right eye feels dry and irritated.
A complete blood count and urinalysis was unremarkable . Further physical examination was done and patient was diagnosed as having Bell’s Palsy or Facial Nerve Paralysis. Patient was immediately given 30 mg Prednisone twice a day for 5 days, then 20mg 2xday for the next 5 days. Vitamin B complex was also given as well as Hypromellose Eye drops (EyeMo Moisturizing Formula) to relieve irritation and dryness of the affected eye.

Bell’s Palsy was named after Sir Charles Bell(1774-1842) who first described the syndrome and is characterized by a temporary paralysis of the facial nerve.There is a loss of facial creases and naso labial fold ,with associated incomplete closure of eyelid,decreased production of tears.The corner of the mouth may show considerable drooping and no furrow or lines over forehead.Facial sensation is usually preserved.

Bell's palsy is a form of temporary facial paralysis resulting from damage or trauma to one of the facial nerves. It is the most common cause of facial paralysis. Generally, Bell's palsy affects only one of the paired facial nerves and one side of the face, however, in rare cases, it can affect both sides. Symptoms of Bell's palsy usually begin suddenly and reach their peak within 48 hours. Symptoms vary from person to person and can range in severity from mild weakness to total paralysis. These symptoms include twitching, weakness, or paralysis, drooping eyelid or corner of the mouth, drooling, dry eye or mouth, impairment of taste, and excessive tearing in the eye. Bell’s palsy often causes significant facial distortion. Most scientists believe that a viral infection such as viral meningitis or the common cold sore virus -- herpes simplex-- can cause the disorder when the facial nerve swells and becomes inflamed in reaction to the infection.(National Institute of Neurological Disorders and Stroke)