Imagine waking up in the morning to find there’s no feeling on one side of your face.
Imagine waking up in the morning to find there's no feeling on one side of your face. As frightening as that sounds, it's a situation that's more common than you might think. The cause is Bell's palsy, and it can quite literally happen to anyone…
It was on a Saturday morning that Ben Gray first noticed the change to his face. "I saw myself in the bathroom mirror and something felt a bit weird," he says. "I could tell something wasn't right, so went back to the mirror and tried to smile, and the right side of my face wasn't cooperating."
The 32-year-old had been feeling ill for a month, and was also struggling with stress. "Apart from having the worst flu of my life, my full-time job and career as a musician were also facing some pretty tough challenges," he says. "When the doctor told me the condition was associated with stress, I wasn't at all surprised."
Ben's condition was diagnosed as Bell's palsy, a rapid-onset form of facial paralysis that can afflict sufferers literally overnight. Ranging in severity from mild weakness to complete paralysis of one side of the face. Bell's palsy usually worsens over the hours and days following its initial onset, often with other symptoms – such as partial loss of the ability to taste – thrown into the mix.
"Your doctor will assess whether you have Bell's palsy or an alternative diagnosis such as a stroke," says neurologist Dr Andrew Kelly from Nexus Neurology (nexusneurology.com.au). "There may be pain in or around the ear on the affected side for a day or two prior to the onset of facial weakness. That same side of the face will often feel numb and some patients may have sensitive hearing on the affected side, or disturbance of taste affecting half the tongue."
In addition, treatment is probably more effective if commenced within the first few days of displaying symptoms.
While its exact causes are unknown, it is thought the condition is probably due to viral infection of the facial nerve by HSV1, the herpes virus responsible for cold sores.
"The virus may lie dormant within nerves, and be reactivated by an illness or stress. And no, the virus is not the one associated with genital herpes."
Bell's palsy is famously indiscriminate in its choice of targets, numbering celebrities George Clooney, Pierce Brosnan, Andrew Lloyd Webber and Roseanne Barr among its sufferers. Recently the condition was thrust into the spotlight when high-profile fashion designer Camilla Franks, 37, and Sydney PR guru Roxy Jacenko, 33, both succumbed.
"It just appeared one Monday," says Roxy, the owner of Sweaty Betty PR. "It wasn't scary as much as confronting because nobody wants to look unlike themselves."
In typical workaholic fashion, she didn't
let the symptoms get in the way of her day's work and it was only when she got home that evening that her family urged her to see
a doctor. "Knowing me, I probably wouldn't have bothered seeing someone!" she says.
While the condition hasn't got in the way of her heavy workload, it is still an irritating handicap. "It's uncomfortable to speak, because you feel like you have a delay between what your brain wants to say and what is coming out of your mouth. For me, as someone who is on constant overdrive, it's frustrating to no end.
"Ultimately though, I have my health so it's really not that bad. There are plenty of people who are very ill and I am very lucky that this is only momentary."
Frightening as it may be at first, anyone diagnosed with the condition can, like Roxy, take consolation in the knowledge that it is likely to be short-lived.
Somewhere in the vicinity of 85 per cent of those afflicted by Bell's palsy do indeed recover within a matter of months.
"The most commonly used treatment is an anti-inflammatory steroid medication that is usually given for a course of seven to ten days," explains Dr Kelly. "This increases the chances of complete recovery from around 80 per cent to about 90 per cent if given early in the course of the illness."
And as for complementary therapies, Dr Kelly explains that there is no evidence to suggest that acupuncture or other alternative treatments increase the likelihood of complete recovery.
Roxy, who is still on the mend, is using steroids to assist recovery, and while side effects are uncommon, she still doesn't feel like her usual self. "I wouldn't wish the steroids upon anyone because they make you feel like you are on some sort of party drug," she says. "If you're hyperactive to begin with, adding these to your day is nightmare stuff!"
Ben Gray, meanwhile, made a complete recovery – enough to joke that he even misses one particular symptom. "It gave my voice a bit of a drawl," he says. "I played a gig with my band and after we finished the set, a friend told me that I sounded like Eddie Vedder. It wasn't all bad!"
While a full recovery is likely, however, the chances are reduced in patients for whom the affected side of the face is completely paralysed, as compared to those who only experience reduced movement. Particular attention should be paid to the eyes – especially if one of them is drooping.
"In patients that are having difficulty closing the eye on the affected side, the eye should be taped shut with appropriate lubrication of the surface to prevent drying of the eye while sleeping," Dr Kelly says. Failure to do so can cause permanent scarring of the cornea – possibly the worst, and completely avoidable, outcome of the disease.
Because of the seemingly random nature of Bell's palsy, there is very little you can do to avoid it. Common wisdom would suggest that, with stress a contributing factor, finding ways to reduce the pressures in your life can only help, as can beefing up your immune system.
Ultimately though, with the cause of the disease not entirely understood, it's best to concentrate on seeking prompt medical attention should symptoms arise.
"Early diagnosis is key because treatment is probably most effective when commenced within the early days of onset," Dr Kelly says. "If you do experience symptoms, it's best to address the situation swiftly."
Face the facts
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Bell's palsy can affect anyone of any age, although the peak age bracket is 20 to 40 years.
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There are 4,000-6,000 cases of Bell's palsy diagnosed in Australia annually.
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Diabetes, pregnancy and the postpartum period are all associated with an increased risk of developing the disease.
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The vast majority of people (over 85 per cent) recover from the condition.