Ever wondered why the left side of NBA superstar Joel Embiid’s face appeared to be drooping and his left eye didn’t seem to be blinking during his recent game? During the postgame press conference, Embiid confirmed that he had been diagnosed with Bell’s palsy, a week before the game. Bell’s palsy presents a perplexing challenge in the realm of neurology, characterized by sudden, one-sided facial nerve paralysis without a clear cause. Unlike other forms of facial paralysis, Bell’s palsy strikes swiftly, often leaving people surprised and confused by its abrupt onset. Although its precise cause remains difficult to define, some possible causes can range from viral to inflammatory or autoimmune origins.
Demographically, Bell’s palsy exhibits a curious pattern, with an estimated incidence of 23 cases per 100,000 individuals, affecting both genders equally. However, it predominantly targets individuals in their twilight years, with a peak incidence observed around the age of 60 and above. Certain predisposing factors, such as advanced age and immunosuppression, can heighten susceptibility to its onset.
Diagnosing Bell’s palsy hinges on a thorough assessment encompassing both history and physical examination. Patients typically recount a sudden emergence (less than 48 hours) of one-sided facial weakness, often coupled with an inability to close one eye—a hallmark feature of the condition. Other symptoms, including posterior auricular pain, diminished tearing, and taste disturbances, further underscore its diagnostic complexity.
The physical examination presents a spectrum of indicative signs, ranging from an expressionless face on the affected side to an inability to execute facial expressions such as winking or smiling. Notably, a comprehensive evaluation of cranial nerve function is imperative, as Bell’s palsy exclusively targets the facial nerve (VII).
A prudent approach is necessary to navigate the maze of differential diagnoses and rule out threatening culprits such as stroke or tumour. Unlike Bell’s palsy, stroke-induced facial paralysis typically spares the upper third of the face, offering a crucial diagnostic clue. Our experienced nurse practitioner, Angena Sathiamoorthy, and our knowledgeable chiropractor, Dr. David Tam, can diagnose Bell’s palsy and rule out other conditions that can cause similar symptoms.
When it comes to management, protecting the health of the eyes takes precedence, requiring actions such as wearing an eye patch and lubricating the eyes. Furthermore, the administration of corticosteroids and antivirals is fundamental in reducing disease progression.
Despite its unpredictable nature, Bell’s palsy often responds well to conservative treatments, with the majority of patients achieving complete recovery within a span of 3 weeks. Massage therapy can offer relief to individuals with Bell’s palsy by stimulating the facial nerves, which can help with facial expressions, such as smiling and closing the eyes. However, a subset of individuals may struggle with residual asymmetry or, in rare cases, severe facial deformities, which would require specialized care.
References
Vizniak, N. A. (2021). Bell’s Palsy. In Evidence-Informed Massage Therapy (2nd ed., pp. 446). Professional Health Systems Inc.
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