What would you think if you woke up one morning and noticed in the mirror that half of your face looked strange? By strange, I mean you couldn't blink one eye and your lips, mouth and tongue didn't move properly. In short, one side of your face was paralyzed.
Would you be concerned that you were having a stroke? Most people would naturally be very scared and concerned that a stroke was indeed occurring.
More than 200 years ago, a Scottish physician named Charles Bell studied the muscles and nerves of the head and face. Twelve major nerves (called cranial nerves) exit from the base of the brain and are variously responsible for movement of facial muscles and tongue, movement of the head and neck, and eye movement. These nerves are also responsible for the senses of touch, sight, hearing, smell and taste in the head, neck, face, eyes, ears, nose and throat. The seventh cranial nerve in particular is responsible for taste at the tip of the tongue, for tearing of the eyes, for the mouth to salivate and for movement of facial muscles. Named after Dr. Charles Bell, Bell's palsy is the temporary impairment of this seventh cranial nerve.
So, to continue with the opening scenario, let's say you find yourself in an urgent care or emergency room and are actually diagnosed with Bell's palsy and you are reassured that it is not a stroke. You go home thankful for the reprieve of a second chance, vowing to clean up your unhealthful lifestyle of fast food, smoking and lack of exercise, all the while wondering why in the world one side of your face is paralyzed.
What causes the impairment of only one nerve, on one side of the head and face and why the seventh cranial nerve? Alas, as in many of medicine's mysteries, we still don't know all the answers. What we do know is that when properly diagnosed, it is safe to say it is not a stroke nor will it progress to a stroke. We also know that when the proper diagnosis is made early enough certain medications can be prescribed to shorten the duration of the paralysis and hasten the return of normal function. Most people recover spontaneously and relatively quickly but sometimes it may take up to six weeks.
Never hesitate to seek medical attention should you develop any of the above mentioned symptoms. Just because Bell's palsy is not a stroke, don't play the denial game and assume that what you are experiencing is only Bell's palsy. Sometimes, even for experienced clinicians, the differences are quite subtle, making accurate diagnosis more difficult. Finally, in both situations, early treatment is essential. When in doubt, check it out.
• Agnes Oblas is a nurse practitioner with a private practice and residence in Ahwatukee Foothills. For questions, or if there is a topic you would like her to address, call her at (602) 405-6320, email at firstname.lastname@example.org or visit www.newpathshealth.com.