Bell's Palsy

One of the complications of mono that can occur in adults is Bell's palsy. This is especially true if you also suffer from diabetes, as diabetics are four times more likely to suffer from Bell's palsy than the average person.

What Is It?

Bell's Palsy is a paralysis of the 7^th cranial nerve of the face and affects one side of the face causing paralysis of the muscles. This particularly affects the eye, preventing normal movement such as blinking and can cause drooping of the eyelid. It may then be difficult for the sufferer to either keep the eye closed, or open.

Symptoms

If you wake up one morning with one side of your face paralysed or semi-paralysed you should see your doctor straight away. This condition needs immediate medical attention as any delay can prevent effective treatment.

Normally if treatment is started quickly, ideally within 72 hours of the onset of symptoms, and no later than 7 days, you can expect a complete or almost complete recovery.

If the condition is left untreated, you may be left with some permanent degree of paralysis to the whole or part of one side of the face. It can also affect the taste buds, make you super-sensitive to sound and give you ‘dry eye' due to the lack of ability to blink.

Some people also have difficulty eating, drinking and speaking and this imbalance in the facial alignment can give an asymmetric smile.

Treatment

Depending on the severity of the paralysis your doctor may prescribe medication to prevent further nerve damage, such as steroids and/or anti-virals. It is also very important that you look after your eyes and use artificial tears.

Many eye doctors also recommend using a protective contact lens to prevent damage to the cornea. It is a good idea to ask your regular doctor to refer you to a specialist for the latest treatments, especially if you don't notice an improvement within a short time.

Some doctors have found that using Botox or even surgery can be helpful if you don't have a quick and full recovery.

Follow Up

Doctors usually recommend follow-up visits during the first year in case there are eye problems and to prevent further damage. Physiotherapy with facial exercises using mirrors can help the muscles relearn the correct movements and prevent healthy muscles from over-compensating for the temporarily paralysed muscles.

A facial retraining therapy specialist may be necessary to enable you to restore full functioning and prevent a permanent facial imbalance if your condition does not resolve itself quickly.

Alternative therapies such as acupuncture can also be helpful. Many doctors also suggest having some psychological support as the sudden change in appearance and the uncertainty of the recovery period can be very disturbing, especially if the facial paralysis is very noticeable.

Fortunately, most cases of Bell's palsy, if treated promptly, recover completely within 3 weeks or so.