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Bell's Palsy

Bell’s palsy is characterised by the palpebral-oculogyric reflex, which refers to the movement of the eyeballs in an upward direction when the eyelids are forcefully closed. Charles Bell, a great British anatomist, first observed this in 1823 when trying to close the eyelids of a patient with facial palsy. Basically, this phenomenon represents a reflex in which the eyes are seen to roll up and out when both eyelids are forcibly closed. The facial nerve carries the afferent fibres for this reflex, while the efferent fibres travel via the oculomotor nerve to the superior rectus muscle that controls upper eyelid movement. In Bell’s palsy, this movement is seen because the eyelids fail to close properly. The House-Brackmann scale is a nerve grading system used to identify the level of facial palsy. Oral corticosteroids have traditionally been prescribed to reduce facial nerve inflammation in patients with Bell's palsy. Facial physiotherapy exercises combined with warm water compresses are also highly effective.