Jo Fisher's 15 Year Experience with Bell's Palsy

Scenario: Bell's palsy

Introduction
Bell's palsy is an acute, unilateral, idiopathic, facial nerve paralysis. The paralysis also affects the eyelids, causing an impairment of blinking. It occurs most commonly between 15 and 60 years of age [DTB, 2006].

The cause remains unclear, but Bell's palsy has been associated with the herpes virus.

What advice can I give people with Bell's palsy?

Reassure the person that the prognosis is good: 85% of people with Bell's palsy make a full recovery within 9 months [Sullivan et al, 2007].

It is important to keep the affected eye lubricated. If the cornea is exposed after attempting to close the eyes, immediate referral to an ophthalmologist is required.

Lubricating eye drops should be used during the day, and eye ointment used at night [DTB, 2006].
If the ability to close the eye at night is impaired, then people should be advised to tape the eye closed at bedtime using microporous tape

Basis for recommendation

The recommendations on eye-care are based on expert opinion [DTB, 2006].
The most significant clinical trial [Sullivan et al, 2007] followed up people after 3 months and 9 months. Most other systematic reviews and randomized controlled trials measured outcomes after 69 months.

Supporting evidence: Evidence on the use of steroids

There are two main benefits from prednisolone: faster recovery, and greater likelihood of complete recovery.

A direct comparison of prednisolone versus no prednisolone [Sullivan et al, 2007] showed that:

At 3 months, full recovery was seen in 83% versus 64% of people; NNT 6 (95% CI 4 to 9).
At 9 months, full recovery was seen in 95% versus 82% of people; NNT 8 (95% CI 6 to 14).

Evidence on the use of anti-viral treatment

A comparison of aciclovir versus no aciclovir [Sullivan et al, 2007] showed:

At 3 months: full recovery was seen in 71% versus 76% of people; NNH not significant.
At 9 months: full recovery was seen in 85.4% versus 90.8% of people; NNH not significant.

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Category:

Education

Tags:

• Bell's
• Palsy

[TheRatadedospatas]

I read all over the place that is good to improve movement in the affected area. I was thinking of giving it a shot. But it's been so long since I got bell's palsy that I am afraid it won't work.

[TheBellspalsychannel]

Treatment of Bell's palsy is still not well-defined.  Conservative approaches entail physiotherapies such as facial exercises, massage, and muscle relaxation, which may support rehabilitation and possibly reduce the production of pathological synkinesia.

[TheBellspalsychannel]

@TheRatadedospatas please note, the nerve needs stimulation to get it to work again, some use acupuncture others use electrical pulse stimulators that trigger nerve conduction and reaction, like the TENS machine (don't have settings set too high and always read any material or research your intended use prior to engagement of treatment). Please seek professional help if you are unsure. Sorry for late response, the BP channel is run by volunteers.

[bent90716]

Im 12

[JamieSandhu]

@tracynichole92 You mean at 8 years old.. dumb ass bells palsy byatch

[mariaaskswhy]

I've had it for 16 years, my entire life. :)

My channel has a video explaining my condition- go forth:P

[tracynichole92]

I have had bells palsy for 10 years now. I am 18 now so at 10 years old, the right side of my face was paralyzed. :(

[jhafes1]

@ettelra73

i was diagnosed of bell's palsy last Nov.11, 2009....and thanks for the help of my physical therapist i got recovered before i could finish my prescribed -12 therapy sessions...i also took vit. b12 ...they say recovery is fast if you will start the treatment 1-3days after the onset of bell's palsy....

[newyork402]

my symptoms strted wen i was 5 they werent that bad tho so my mum never rele notised she just thought i would grow out of it i am now 15 nd my hole left side is drooppy my smile is croked my eye is smaller then the other one. because i have had it for so long is thhere any thing to possibly help me.. people are aleways asking me haVE i had a stroke nd i always feel self consious //////////////?????????????

[ettelra73]

I had BP for 2 years. Thanx for this channel! God Bless!

[TheBellspalsychannel]

Vitamin B12 has also been documented to improve the symptoms of Bells palsy. In one study, three groups of patients were tested: one received methylcobalamin (vitamin B12), one received corticosteroids, and the third received methylcobalamin in combination with corticosteroids. At the end of the study, the patients in both methylcobalamin groups showed greater improvement in their symptoms than those in the corticosteroid group (Jalaludin MA 1995).