It is a unilateral, peripheral facial paresis or paralysis that has an abrupt onset and no detectable cause. Bell palsy is one of the most common neurologic disorders affecting the cranial nerves, and it is certainly the most common cause of facial paralysis worldwide.

The onset of Bell's palsy can be frightening for patients, who often fear that they got stroke or have brain tumor or distortion of their facial appearance will be permanent.

Important factors to remember:
• Initiate appropriate treatment.
• Protect the eye.
• Arrange appropriate medical follow-up care.

Pathophysiology
Inflammation and swelling of the facial nerve results in compression of the nerve within the temporal bone.

Anatomy
The facial nerve (seventh cranial nerve) has 2 components. The larger portion comprises efferent fibers that stimulate the muscles of facial expression. The smaller afferent portion contains taste fibers to the anterior two thirds of the tongue, secretomotor fibers to the lacrimal and salivary glands, and some pain fibers.

Frequency
The condition affects approximately 1 person in 65 in a lifetime. However, the incidence is significantly higher in persons with diabetes mellitus than in those without diabetes.
Bell's palsy can also be recurrent, occurring about 7% of the time.
The incidence of Bell's palsy increases between the ages of 10 and 30 years. Bell's palsy is least common in persons younger than 10 years and most common in those older than 70 years.
It can be equally in both sexes.

Mortality/Morbidity

Bell's palsy can cause aesthetic, functional, and psychological disturbances in patients who have residual nerve dysfunction during their recovery phase or in patients with incomplete healing.
• Partial paralysis
• Motor synkinesis (involuntary movement accompanying a voluntary movement)
• Autonomic synkinesis (involuntary lacrimation after a voluntary muscle movement)

Clinical

History

The most common complaint is of weakness on one side of the face.
• Approximately 50% of patients experience pain in behind ear. (Mastoid region).The pain frequently occurs simultaneously with the paresis, but precedes the paresis by 2-3 days in about 25% of patients.
• Tear flow: Two thirds of patients complain about tear flow.
• Altered taste: While only one third of patients complain about taste disorders.
• Dry eyes
• Impaired tolerance to typical levels of noise.

Physical Findings of facial paralysis:

• Weakness and/or paralysis of the affected side of the face.
• Eye closure on the affected side may be partially or completely impaired.
• Nasolabial fold can be visualized on the opposite side of affected area.

Causes
• Viral infections
• Mycoplasma infection
• Genetics
• Cold climate (cold air exposure )

The following are some of the symptoms of Bell's palsy:
• Throbbing pain and sensitivity to touch
• Redness and hot swelling
• Fever with chills and body ache
• Discharge of pus and blood when the abscess breaks
• Enlargement of regional lymph nodes
• Generally, all abscesses feel warm due to increase in blood circulation; however, tubercular abscesses usually remain cold (hence, they are referred to as ‘cold abscesses’). They too need immediate critical care.

Lancing (cutting of the abscess) can be avoided with timely Homeopathic treatment to - Reduce the size of inflammation Reduce the pain Promote suppuration and drainage Homeopathy can effectively increase the immune system which helps to overcome the recurrent abscess and boils.