What is Bell's palsy? The condition Tulisa has spoken out on
Singer Tulisa Contostavlos, who is set to appear in the new series of I'm A Celebrity... Get Me Out of Here!, has previously spoken out about living with the condition Bell's palsy, which sees one half of the face become paralysed. This can lead to features dropping and the person suffering may struggle with things like raising an eyebrow or smiling.
"I do suffer from Bell's palsy [...] it can cause facial paralysis, it can cause swelling," Tulisa explained during a previous interview on Loose Women. "I think the first attack I had was after a serious horse-riding accident. I fractured my skull and it caused a lot of nerve damage.
"At any time, I have emergency steroids on me, and now luckily I know how to manage it, so the attacks don't last as long. There have actually been times when people have criticised me for the way I look and my face, not knowing I'm actually going through a Bell's palsy attack."
Tulisa isn't the only celebrity to have appeared on the show with Bell's palsy either, with previous jungle winner, Scarlett Moffatt, also having a Bell's palsy diagnosis, which prevented her from taking part in some of the trials during her season.
But what actually is Bell's palsy, and do we know what causes it? And just as importantly: what treatment and support is there for Bell's palsy? We asked Catriona Neville, an extended scope practitioner physiotherapist specialising in facial palsy within the NHS, who is also on the Facial Palsy UK medical advisory board.
What is Bell's palsy?
In short, Bell's palsy is a facial paralysis condition, thought to impact around 20-30 per 100,000 people (or 1 in 60 at some point in their lifetime), according to the Cleveland Clinic). Typically, it sees one half of the face become paralysed, but in rare instances, both sides of the face could be affected.
Neville explains that there's no conclusive reason why Bell's palsy occurs, but there are links to viruses that cause swelling around the facial nerve. "The pressure from this swelling damages the facial nerve and stops signals getting from the brain to the face. Therefore the face is unable to work normally."
While Bell's palsy may be the most common type of facial palsy, making up 80% of cases, there are many other forms of facial palsy, which can span from tumours to infection, being born with facial palsy or another neurological condition.
"The impact of facial palsy is extreme. A complete facial palsy affects the whole side of the face and it usually happens very suddenly," says Neville. "Movements such as raising the eyebrow, closing the eye, smiling and moving the lips are no longer possible. Because the muscles are not able to work the face can look dropped on one side. Being unable to move your face makes activities that we take for granted very difficult. This includes eating, drinking, speaking, whistling and kissing amongst many others."
In addition to that, the way we communicate with one another often involves facial expressions and this can create a challenge for people when trying to express emotions.
How does Bell's palsy impact people?
"People with Bell's palsy can get a very dry, painful eye due to being unable to close their eye or produce tears when the nerves stop working," says Neville. "The mouth can also become dry and taste can be affected. Noise can be unbearably loud in the affected ear because the sound muffling muscle stops working. The face can stiffen up within days of not moving, which can make it uncomfortable or even painful."
The expert adds that some people who don't recover quickly go on to develop a condition called synkinesis. "This is when the affected side of the face becomes extremely overactive and tight. The tight muscles restrict movement as well as being extremely distracting and uncomfortable."
Can Bell's palsy affect your mental health?
Unfortunately, facial paralysis can have a wider impact than just the physical, says Neville. Mental health and confidence may also be effected by Bell's palsy.
"All these physical and functional difficulties have a significant impact on people's confidence and can result in people becoming anxious, depressed, lacking in self-esteem and even socially withdrawn," the specialist shares. "It can stop people working, affect relationships and in extreme cases, make people feel that life isn’t worth living."
This is obviously heartbreaking to hear – so it's important that if you're dealing with facial palsy of any kind and feel it's having a detrimental impact on your mind, you reach out to your GP, loved ones and/or a charity, like Facial Palsy UK, for support.
How can you treat Bell's palsy?
There are some incredible treatment options and support services out there, says Neville. "There is hope! If you get facial palsy, see your GP or visit A&E urgently, as the most important treatment is taking high dose steroids within 72 hours of the facial palsy starting," she explains. "This doesn't guarantee recovery but it does reduce the swelling on the nerve which can speed up recovery. If you are also in a lot of pain you may have a more severe virus and should then be given anti-viral medication as well."
During the acute stage, taking the appropriate medication and resting up, in order to give yourself the best shot at a full recovery, is key. "As the eye won't close, it needs to be carefully looked after and may need eye drops, ointments or to be taped closed. Facial massage can stop the face getting stiff which may help recovery be a little quicker," Neville recommends.
As for things not to do when recovering from Bell's palsy, Neville says you should not try to force your face into moving. "When the nerve is not working, no amount of effort can make the face move and bad habits can be developed leading to long term facial stiffness and over activity."
Around 70% of patients will make a full recovery within about 6 weeks without needing any further intervention, she adds. "For the 30% of people who don't make an immediate recovery, they will usually start to see some recovery happening about 16 weeks after the facial palsy starts as their nerve regenerates. This group are more at risk of complications and should be seen by a specialist facial palsy team."
Further next steps may include injections, surgery, facial movement retraining and therapy. "Lots of advice and support can be accessed via the Facial Palsy UK charity and they can also help people find their most local facial palsy specialist centre."
To learn more about Bell's palsy or any kind of facial palsy, visit Facial Palsy UK
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