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Neurological disorders—as Angelina Jolie recently recounted—have a way of viscerally reminding people to take stock of their health. The root cause of Bell’s palsy, the condition that damaged the actress and activist’s nerves and resulted in drooping facial features, can rarely be pinpointed, though a common cold virus is often to blame, according to Dr. Reza Jarrahy, codirector of the UCLA Craniofacial Clinic.
For Jolie, the diagnosis was a wake-up call. “Sometimes women in families put themselves last,” she told Vanity Fair, “until it manifests itself in their own health.” The condition prompted Jolie to take charge of her own well-being and proactively seek acupuncture to reduce the nerve damage brought on by inflammation. But Bell’s palsy—affecting about 40,000 people a year, according to the National Institute of Neurological Disorders—is still something of a neurological mystery. Here, a primer on its sudden onset, telltale symptoms, and restorative treatments.
A Diagnostic Anomaly
Like many neurological disorders, a lab test can’t tell doctors whether or not a person has Bell’s palsy. And, like so many maladies, inflammation triggers it, so those with underlying diseases including diabetes, high blood pressure, autoimmune disorders, or tumors are more susceptible—but anyone can get it. Sudden weakness on one side of your face is the most common initial symptom, explains Jarrahy. Because part of your face basically goes limp, it’s immediately obvious that something is up. Essentially, the nerve used to raise eyebrows, close eyes, and purse lips stops working. But Jarrahy says doctors rely on a “diagnosis of exclusion to make sure there isn’t a brain tumor or evidence of something more serious.”
A Short in the System
The nerve triggering Bell’s palsy starts in the brain stem, travels through a canal by the ear, then branches out. So when it gets inflamed and swells near the ear, the nerve shuts down. And, because your body is really a living circuit board, random features of your face shut down. “The affected nerve has multiple branches leading to one’s forehead, eyes, cheeks, and lips,” Jarrahy explains. So Bell’s palsy can affect all of them or just one. “It depends on how extensively the nerve is damaged,” he says.
Restoring Equilibrium
Mild cases of Bell’s palsy go away in a few weeks, but, for some, symptoms can last for months. Treating the underlying viral infection and reducing inflammation is an important first step. “If you think the palsy may be due to a viral infection, you can use steroids to decrease swelling, and, in turn, to decrease the length of time you have symptoms,” Jarrahy says. Drops to protect eye corneas exposed by errant blinking are also key. Stimulating facial nerves with acupuncture or massage can also help restore feeling and function—and symmetry.