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Bell's Palsy

The good news is that Bell's Palsy can be treated!
Bell's Palsy involves the sudden onset of weakness on one side of the face due to pressure on the facial nerve. The exact cause is unknown, however it is believed that inflammation of the facial nerve is at fault. Before the facial nerve enters the face it travels through a small boney canal just behind the ear. Due to this confined space there is no room for swelling.

The facial nerve is broken down into 4 branches as it enters the face:
1) the temporal 2) zygomatic 3) buccal 4) mandibular branches.

The face is made up of many small muscles. The amount of damage to the facial nerve depends on the amount and duration of pressure on the nerve. The facial nerve is covered by 3 layers of insulation;
1) epineurium 2) perineurium 3) endoneurium.
The deeper the pressure the more significant the damage.

Approximately 80 % of people have full recovery within the first 4 to 6 weeks. The remaining 20 % are left with continued facial weakness or tightness.

Increased tightness is termed synkenesis. An example of synkenesis is when the eye closes with a smile or an intermittent but persistent, uncontrollable twitch of the eye, cheek or chin on the damaged side.

The aim of Physiotherapy is to promote balance of muscle activity between the two sides of the face. Avoidance of mass movement patterns such as exaggerated expressions is important. This acts to strengthen the good side and can create further muscle imbalance.

Treatment at this clinic includes:
  • Education regarding Bell's palsy
  • Treatment and exercises individually designed according to the symptoms and muscles involved
  • A home program of exercise and compliance are a must.

Physiotherapy by a physiotherapist trained in facial nerve rehabilitation can be beneficial even years after onset.

Faye Cronan is one of a few physiotherapists trained in Facial Nerve Rehabilitation in Canada. See for details.

All that appears to be Bell's may not necessarily be. If you experience dizziness, ringing in the ears, weakness in the arm/leg associated with facial weakness or a repeat onset of Bell's Palsy on the same side see your physician for further investigation.