On call: Bell's palsy
On call
The problem is caused by the inflammation of the facial, or seventh, cranial nerve. It begins abruptly with a weakness on one side of the face that increases to its maximum over 1–2 days and then stabilizes. Many patients complain of pain behind the ear on the affected side of the face, and some experience abnormally acute hearing in that ear. A less common symptom is a diminished sense of taste on half the tongue. Because the eyelid muscles are weak, patients can't blink or close their eyes fully, so eye dryness and irritation can be troublesome. The weakness involves the entire face from head to chin, but it ranges in severity from mild weakness to a nearly complete paralysis. About 85% of patients recover completely, but improvement can be slow, taking several months. Facial weakness can sometimes persist, especially in patients with the most severe cases.
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