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What is Bell’s Palsy

Bell’s palsy is a weakness in the function of the seventh cranial nerve. This nerve has many functions, but the most important function is to transmit impulses from the brain to certain muscles in the face, sometimes called the muscles of facial expression. Chewing muscles (medically known as muscles of mastication) will be unaffected.

Parents are often frightened by Bell’s Palsy because they may note the superficial similarity to the manifestations of some strokes, perhaps one suffered by an elderly relative. Strokes are rare in children, and a thorough neurologic exam by a qualified individual will differentiate between the two. This is of utmost importance because strokes (medically known as cerebrovascular accidents) result in permanent deficits and define an individual as at increased risk of more strokes and/or heart attacks.

Bell’s Palsy ultimately resolves, leaving normal or near normal function in the vast majority of cases.

Important points

Bell’s Palsy by definition has an unknown cause. Efforts should be made to make sure that there is not a treatable cause of the seventh nerve weakness, for example Lyme disease, or Syphilis.
The child should be seen as soon as possible to make sure that the facial weakness is not a stroke. If the weakness is first noted after the close of office hours, the child should be seen in an emergency department.

If the child’s eye does not completely close during sleep or while blinking, then ocular lubricants should be used during the day, and the lid taped closed with scotch tape at bedtime.