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Q. What causes Bell’s palsy?

A. Bell’s palsy is a brief partial facial paralysis that happens when the nerve controlling the facial muscle mass is infected. However figuring out the underlying reason for the irritation “is a query for the ages,” mentioned Dr. Joseph Safdieh, a neurologist at Weill Cornell Medication and a fellow of the American Academy of Neurology.

The present prevailing idea is that Bell’s palsy develops after a viral an infection prompts the immune system, Dr. Safdieh mentioned, including that “as soon as the immune system is activated, it goes and assaults a nerve.” The situation normally impacts just one aspect of the face, inflicting asymmetry or drooping on one aspect (the explanation for that’s not recognized both).

Some consultants imagine Bell’s palsy is expounded to the herpes simplex or widespread chilly sore virus. However a number of giant randomized managed trials that in contrast therapy with antiviral brokers and prednisolone, an oral steroid that suppresses the immune system, discovered the steroid to be handiest. The outcomes reinforce the concept that the situation is brought on by an immune system response moderately than the virus itself, Dr. Safdieh mentioned.

The situation has additionally been related to current vaccinations and higher respiratory infections, “however many individuals are vaccinated and have higher respiratory infections and don’t develop Bell’s palsy,” Dr. Safdieh mentioned. “The final word reply is ‘we don’t know,’ however that many issues that activate the immune system can set off it.”

One particular trigger that needs to be dominated out is Lyme illness, particularly if Bell’s palsy develops in the summertime or early fall or in youngsters, in whom it’s much less widespread, Dr. Safdieh mentioned. Remedy will differ if the affected person has Lyme illness.

Bell’s palsy can also be related to sarcoidosis, an inflammatory illness that entails different components of the physique as effectively and is extra widespread in African-Individuals; each being pregnant and diabetes improve the danger for Bell’s palsy.

Bell’s palsy is usually handled with oral steroids, akin to prednisone or prednisolone. The sooner therapy begins, the higher, however “most sufferers have a whole restoration inside three months,” Dr. Safdieh mentioned, although generally signs last more and, in uncommon instances, by no means utterly disappear. The dysfunction may additionally recur.

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