Neuritis: A Look into the New Bell’s Palsy Etiologies

Written By Rhyana Mahatsente Tewelde

Bell’s Palsy

Rapid, unknown, and occurring among thousands of Americans is a neurological condition that affects nerves in the face resulting in immobility of regions of the face. Occurring in almost all groups, its etiology is often a blur and can be misdiagnosed a result of other illnesses beholding similar effects. Among the majority of patients, the condition often lasts for a short period of time and is diagnosed by physicians. Upcoming etiologies can be discovered and more focused has been put towards nerves that are specific targets for the muscles affected. A step forward into this research has been in the study of neuritis. 

Neuritis

According to Merriam Webster, neuritis can be defined as “an inflammatory or degenerative lesion of a nerve marked especially by pain, sensory disturbances, and impaired or lost reflexes. As neuritis affects nerves that result in Bell’s Palsy by resulting in enlargement or swelling, research is vital to further progress in Bell’s Palsy treatment and prevention. This swelling of nerves results in short-term or long lasting inability or difficult use of the nerve resulting in impairment in facial movements. Neuritis in Bell’s Palsy has a focal research point among the Cranial Nerve VII. Outside of its function regarding movement of muscles in the face, the Cranial nerve VII functions in our sense of taste. Among other functions of taste, the nerve receives information regarding taste from ⅔ of the tongue (Walker 1990). While neuritis is considered as an etiology for this disorder, the methodology of limiting out previous causes must be explored. 

Magnetic Resonance Imaging 

Magnetic Resonance Imaging is a type of neuroimaging that looks at structural abnormalities in regions of the body and is a frontliner in a large number of neuroscience research. According to Johns Hopkins Medicine, magnetic waves are utilized in order to obtain such images. Images from these scans are presented in slices which allow for a better look and more observation into the progression of illnesses as well as internal damage. In the illness of Bell’s Palsy, an MRI would shed light on structural abnormalities allowing for more illness progression to be identified. While MRIs provide an abundance of information in diagnosing Bell’s Palsy and identifying as root cause of the paralysis, they only provide structural information leaving a realm of knowledge incapable of being accessed as well as not providing direct link between Bell’s Palsy as the root cause for the paralysis. 

Blood Work

Blood testing often occurs in hospitals and clinics, allowing for information regarding etiologies to be seen. This allows for bloodwork to be easily accessible allowing for more cases of Bell’s Palsy to be found. In the context of Bell’s Palsy, blood work rules out other etiologies. Cleveland Clinic states “Other conditions, including stroke, sarcoidosis, Lyme disease, middle ear bacterial infections, multiple sclerosis and tumors near your facial nerve can sometimes cause facial paralysis that’s similar to Bell’s Palsy.” This shows that due to the numerous similarities in symptoms shared among illnesses listed above, bloodwork is required to differentiate patients who carry similar symptoms and guide patients with Bell’s Palsy towards optimal treatment options. After determining patient’s have Bell’s Palsy, immense research is put into possible causes of this sudden facial immobility, as seen in neuritis approaches however as researchers delve into this condition they progress in finding causes for the nerves afflicted. 

Vascular Theory 

While knowledge turns attention towards neuritis as a root cause for Bell’s Palsy spurs, theories such as the vascular theory dissect root causes of this nerve failure; which encompasses several symptoms associated with the disorder. Vascular theory aspect of primary Ischemia proposes the idea that inside the nerves blood flow is disrupted, leading to less blood in the nerves causing a form of paralysis known in Bell’s Palsy. This vascular theory may be at the heart of neuritis by proposing that this disruption in flow leads to an immobile nerve and a nerve rather than just swelled but injured. This provides a deeper understanding towards an effect that leads to Bell’s Palsy allowing for more understanding regarding how the nerve faces this issue. 

Discussion

Throughout this analysis, we have seen that Bell’s Palsy, whether temporary or suddenly long lasting, can produce an effect on muscles in the face resulting in immobility or affecting its appearance. Scientists have theorized a possible etiology for Bell Palsy as neuritis or the swelling and injuring of facial nerves, specifically cranial nerve VII. As this theory begins to gain ground, more research should occur regarding creating more accurate and reliable forms of ruling out other diseases and make this more concise and available. As blood work becomes more accessible, less will need to rely on MRIs for diagnoses. The vascular theory and its theory subsections allow for greater evidence for the neuritis approach to Bell’s Palsy etiology, however more research is necessary to prove such an occurrence. In order for this theory to gain more support, medical and clinical observations of Bell’s Palsy is necessary, allowing for more observations to be made regarding the future of Bell’s Palsy treatments and hopefully cure.

References

“Magnetic Resonance Imaging (MRI).” Johns Hopkins Medicine, 29 Aug. 2023, www.hopkinsmedicine.org/health/treatment-tests-and-therapies/magnetic-resonance-imaging-mri. 

Cleveland Clinic medical. “Bell’s Palsy.” Cleveland Clinic, my.clevelandclinic.org/health/diseases/5457-bells-palsy. Accessed 31 Dec. 2023. 

“Bell’s Palsy.” Johns Hopkins Medicine, 8 Mar. 2023, www.hopkinsmedicine.org/health/conditions-and-diseases/bells-palsy#:~:text=Bell%27s%20palsy%20is%20an%20unexplained,of%20the%20face%20or%20head. 

Kahn, April. “Bell’s Palsy: Causes, Symptoms, Diagnosis, Treatment, Outlook.” Healthline, Healthline Media, 26 Apr. 2023, www.healthline.com/health/bells-palsy. 

“Bell’s Palsy.” National Institute of Neurological Disorders and Stroke, U.S. Department of Health and Human Services, www.ninds.nih.gov/health-information/disorders/bells-palsy#toc-what-is-bell-s-palsy-. Accessed 31 Dec. 2023. 

Grewal, D S. “Bell’s Palsy-Tertiary Ischemia: An Etiological Factor in Residual Facial Palsy.” Indian Journal of Otolaryngology and Head and Neck Surgery : Official Publication of the Association of Otolaryngologists of India, U.S. National Library of Medicine, Sept. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6127045/. 

Cranial Nerve VII: The Facial Nerve and Taste - Clinical Methods - NCBI ..., www.ncbi.nlm.nih.gov/books/NBK385/. Accessed 1 Jan. 2024. 

“Neuritis Definition & Meaning.” Merriam-Webster, Merriam-Webster, www.merriam-webster.com/dictionary/neuritis#:~:text=%3A%20an%20inflammatory%20or%20degenerative%20lesion,and%20impaired%20or%20lost%20reflexes. Accessed 1 Jan. 2024.