Ball's Palsy: The facial paralysis that's affected A-listers like Angelina Jolie and George Clooney

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Bell's Palsy: The facial paralysis that's affected A-listers like Angelina Jolie and George Clooney

USA TODAYPublished 5:56 p.m. ET July 26, 2017 | Updated 5:58 p.m. ET July 26, 2017


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In a new interview in the September  issue of Vanity Fair published Wednesday, Angelina Jolie went public with a diagnosis of Bell's Palsy, a type of temporary facial paralysis.
“Sometimes women in families put themselves last,” she says, “until it manifests itself in their own health,” she told the magazine, noting that she had it last year and that acupuncture helped her recover fully.

What is it?

According to the National Institutes of Health's National Institute of Neurological Disorders and Stroke, Bell's Palsy is caused by damage or trauma to the facial nerve (also known as the seventh cranial nerve), causing a disruption of the nerve signal somewhere between its origin at the brain stem to the muscles on either side of the patient's face, causing that side to droop. Blinking, smiling, the raising of eyebrows, flaring of nostrils and even taste sensation can also be affected since the same nerve is responsible for those functions.
In most cases, only one side of the face is affected, though it can affect both.

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What causes it?

Jolie mentioned in her interview that she'd also been diagnosed with hypertension, or high blood pressure, which has been linked to Bell's Palsy, along with diabetes, Lyme disease and autoimmune disorders, chronic ear infections, tumors and trauma to the head or face.
It's often been linked to stress, although a single, precise cause has not been found. 
The NIH says many doctors believe viral infection or viral meningitis create a situation in which the facial nerve swells within its canal, restricting the flow of blood and oxygen throughout the nerve.
In minor cases, only the myelin sheath, or the nerve's fatty insulation, is affected, rather than the nerve fibers themselves. (The myelin sheath is the same tissue affected by multiple sclerosis.)

What are the symptoms?

One of the patient's eyelids may droop or one eye might produce more tears than the unaffected side.
The mouth may also droop, produce excess saliva (or not enough) and the sense of taste may be affected, along with the patient's ability to eat or drink.
Hypersensitivity to sound, ringing in the ears, headaches, dizziness and impaired speech can also be signs of Bell's Palsy.
The symptoms often occur suddenly and peak within 48 hours.

How is it diagnosed and treated?

No single laboratory test can determine whether a patient has Bell's Palsy. It's a game of eliminating other causes of facial paralysis. MRIs and CT scans may be used to rule other causes.
Otolaryngologists (head-and-neck specialists) treating the disorder may also use electromyography to test nerve function by measuring muscle cell reaction to electrical or neurological activation.
If the eyes are affected, doctors often recommend eye drops or eye patches for protection during the recovery process.
Mild cases of Bell's Palsy may go away on their own within two weeks. If symptoms persist, it may be treated with pain relievers or steroids (often prednisone) to reduce swelling.
Most patients recover fully within three to six months, though some may never rid themselves of it or may suffer a recurrence. 

Who gets it?

According to the NIH, there are some 40,000 cases of Bell's Palsy per year with most affecting people between the ages of 15 and 60. 
People with diabetes or upper respiratory ailments are at particular risk.

Which other famous people have had Bell's Palsy?

George Clooney: The actor was a 14-year-old boy when milk dribbled out of his mouth during a post-church lunch. He feared the worst. "I thought, 'Oh, my God, I have Lou Gehrig's disease,'" he told CNN's Larry King in 2006. By comparison, his Bell's Palsy, which lasted about nine months, wasn't so bad. Still, he noted, "It was the first year of high school, which was a bad time for having half your face paralyzed."
Pierce Brosnan: The former James Bond actor told TV Guide he suffered from it in the 1980s after catching a virus while shooting a shirtless scene in a river. He was put on prednisone and had to be shot from the left side to mask the disorder, which went away a few weeks later.
The Mountain from Game of Thrones: Icelandic actor Hafþór Júlíus Björnssonshared his diagnosis earlier this spring on Instagram. It didn't stop him from winning the title of Europe's Strongest Man, though he understandably told fans he wouldn't be able to smile for photos.
Joe Mantegna: The Criminal Minds star was diagnosed with Bell's Palsy in the 1980s while starring in the play Speed the Plow.  "My character (a high-powered movie producer) was on stage the whole time and that adds a lot of stress because you never get to catch your breath," he told the Los Angeles Times in 1988. "While I was doing the play, I came down with Bell's Palsy, which is a stress-related illness, and I'm sure the play had something to do with my getting it."