University of Maryland Global Campus

Running head: BELL’S PALSY 1


Final Research Paper

Nicole Semelsberger

University of Maryland Global Campus



Bell’s palsy is a condition causing paralysis of the face, which typically only impacts one side of the face in most individuals but it is not uncommon for both sides to also be affected. Symptoms are mostly developing overnight, affecting the cran                                     ial nerve resulting in facial drop on one side. Weak immunity, infections and ischemic features are among the most significant cause to development of the Bell’s palsy, but the exact cause remains unclear. In the recent research that has been published, suggests that steroid monotherapy, combined with corticosteroid and antivirals are having an important role in a particular case of Bell’s palsy. And for individuals who are suffering from long recovery, needs to see a medical care provider. Professional collaborations between the medical team and other subjective bodies have proved to be active through physiotherapy, toxin injections and selected type of surgical interventions have helped in reducing the burden of prolonged facial disability.


The facial expressions of humans are significant communication part. Specific movements of brows, eyes, and mouth show universal natural emotions. Facial expressions involve direct influence on subjective feeling for strengthening of emotions while its suppression weakens those emotions. The theory is known as the facial feedback hypothesis (FFH), as was suggested by Charles Darwin and was backed by several studies. The characteristic appearance of this condition is rapid onset, facial weakness in the lower motor neuron, and also symptoms of consistent facial changes (Kheirkhah et al., 2020). The facial nerve’s anatomical structure can be examined considering the clinical appearance, precisely, by observing the nerve profile that contains the motor, sense, and parasympathetic fibers. The facial nerve’s subjective form in connecting to the cranial nerves is also explaining the frequently observed properties in altering the facial sensation. As indicated earlier, facial membrane receptors reoccur information to the brain. When the response is conscious, it is observed as an emotional reaction. Izard suggested that the brain stem’s central neural activity, the limbic cortex, with the hypothalamus is activated by sensitive stimulus perception. And an indication is then directed from the hypothalamus toward facial muscles to the brain stem, and thalamus (Greco, Gallo, Marinelli, Macro & De Vincentiis, 2012). Consistently, the recent study suggested that deliberate facial expression imitation is connected to neuronal activation in the amygdala or any other limbic region, which is linked to the hypothalamus and areas of the brain stem.

In a review analysis of this article, “Abnormal Emotional Processing and Emotional Experience in Patients with Peripheral Facial Nerve Paralysis: A MEG Study,” several conclusions were made. The study by Kheirkhah et al. (2020) aimed to examine how the brain reacts abnormally to situations in clients with facial nerve paralysis. This study’s research question was investigating patients with facial nerve paralysis based on their brains’ unusual emotional responses. The hypothesis for the study was to evaluate an emotion grading task to determine variations in such patients. Through this, it would be easier to discover the brain’s abnormal emotional reactions for patients living with facial nerve paralysis syndrome.

The author’s used 33 subjects, both male and female. However, 17 of the items in this study were healthy, and 16 were identified patients with facial nerve paralysis condition. The female subjects were 25, and the remaining number were male. The method used to test the research question and hypothesis was a logistic regression machine learning technique with LASSO regularization. The patients’ diagnosis was made using brain frequency bands spectrums to examine the differences in emotional reaction.

According to Kheirkhah et al. (2020), healthy subjects have less emotional reactions or responses than patients with facial nerve paralysis. All the tests were based on unpleasant, pleasant, and neutral stimuli for both items for the study. These results established a classification accuracy of brain-neutral responses for healthy people and facial nerve paralysis patients. It was because patients didn’t want to experiment. This study showcased that there is a difference in emotional brain processing for facial nerve paralysis patients compared to healthy people.

Emotional Factors Contributing to Facial Paralysis

Goldberg and Harte have shared quick facts facial paralysis in this article, “Emotional Factors Contributing to Facial Paralysis,” published initially in 1972. As the title of the topic suggests, the authors focused on investigating emotional aspects contributing to facial paralysis. This study’s research question was to examine the psychological factors that majorly resulted in facial paralysis among patients with this related syndrome. The hypothesis was to identify the historical reviews of emotions for the subjects of the study. Also, to ascertain facial nerve variations from different physiological blocks that completed the degeneration of paralysis.

The subjects used in this study were that patients affected with facial paralysis since the main objective was to ascertain the emotional factors that could lead to paralysis degeneration. According to Goldberg & Harte (1972), determining psychological factors effects requires examining marital backgrounds, vocational aspects, and pre-morbid personalities. The methodology used for this study based on data generated from healthcare organizations with facial paralysis patients. They were considering the emotional status based on a psychiatric method assessment to ascertain the levels of psychological trauma if available for each patient. More than 100 patients were reviewed to outline the rate number of emotional trauma experienced.

The finding of this research was that emotional trauma preceded the onset of facial paralysis patients. Every seven patients out of forty-four experienced psychological trauma that caused their facial paralysis; thus, the research question was attested. This study is significant because it has stated some of the facial disease’s etiological factors, which is emotional trauma. It has contributed an understanding of what’s required to control patients with facial paralysis conditions. This study has also demonstrated that emotional crisis and severe anxiety should be avoided because it can lead to facial paralysis in the long run.

Bell’s Palsy and Autoimmunity

In this article, “Bell’s Palsy and Autoimmunity,” the authors focused on discussing disease etiopathogenesis and pharmacotherapy. It is a syndrome that affects the idiopathic peripheral facial nerve. In a review analysis of this study, the author’s articulated all unilateral facial nerve palsy to outline the prevalence of Bell’s palsy nerve condition and autoimmunity. The research questions that were being tested included reviewing the current knowledge of Bell’s Palsy, the viral infection frequency, and autoimmunity. The hypothesis for the research study was to discuss the pathogenesis of this nerve syndrome basing on pharmacotherapy. As a result, to understand the etiology of Bell’s Palsy and its autoimmunity.

The subjects used to develop this research based on relevant publications on Bell’s palsy condition using clinical presentation, histopathology, and diagnosis. All the research publications used in this study were from 1975-2012 to ascertain this syndrome’s frequency in patients. The number of these publications was 82. The method used to establish Bell’s palsy frequency was built from the 82 relevant papers. The etiology, diagnosis, treatment, autoimmunity, and clinical presentation of this syndrome in patients were outlined. And discussed according to Greco, Marinelli, Marci, & De Vincentiis, (2012), Bell’s Palsy accounts for 60-75% of unilateral facial nerve diseases, and the annual occurrence is 15-30 people per 100,000 persons. It was also found that it caused by the reactivation of latent herpes viruses from cranial nerve ganglia. However, it was concluded that Bell’s Palsy is an autoimmune condition. As a result, the hypothesis and research questions were both tested and discussed. This study’s importance is that the diagnosis, occurrence, treatment, and the history of Bell’s Palsy are given.

Disrupted Functional Connectivity of Striatal Sub-Regions in Bell’s Palsy Patients

Striatal useful connectivity in people with a motor disorder such as Parkinson’s disease have limited research studies. In this article, “Disrupted Functional Connectivity of Striatal Sub-Regions in Bell’s Palsy Patients,” numerous facts have been made regarding motor disorders. The study aimed to investigate how striatum controls motor functions in people and how its degeneration can cause severe complications. The research question examined how functional connectivity is affected by peripheral nerve injury between the motor cortex and the striatum. This study focused on Bell’s Palsy (BP) clients and healthy people to ascertain the difference.

The subjects used to carry out this study were 25 Chinese right-handed patients with left/right-sided BP syndrome. Out of the 25 items, 15 were male, and ten were female without psychiatric disorders. The methodology used was MRI data processing, with each subjects’ eyes scanned and a seed-based approach applied to eliminate correlations. According to Song et al. (2017), BP patients had disrupted striatal because the striatum and the putamen were affected. The condition was regardless of gender. Contrarily, the healthy people had more reliable functional connectivity because of the secure sensorimotor area. The disruptive functional connectivity was all factored by nerve injury of the caudate and putamen.

This study has helped lay out a comprehensive understanding of striatal functional connectivity in patients with BP syndrome. Through this, it is easier to identify what causes BP syndrome condition, and it can help in identifying recovery solutions for such patients. More studies must still be developed to examine disruptive functional connectivity for BP patients in acute, late, and recovery stages. This study has shared the vital role that striatum plays in motor functions in the human body system.


Finally, the experiences of emotions and the brain’s emotional replies in cranial nerve paralysis patients are disconnected after patients in precise controls of particular emotional reactions. Facial language ability is essential for the regular processing of emotions and emotional experiences (Kheirkhah et al., 2020). Treating and managing Atypical Sensitivity and Experience in Patients suffering from Marginal Cranial Nerve Paralysis is becoming a challenge because no one can predict the outcome. Homeopathic therapy and lifestyle changes can be a great help in reducing or managing the indications of facial paralysis (Kheirkhah et al., 2020). The prognosis of people suffering from Bell’s Palsy is considered good because the extent to which the nerve is damaged is proportional to recovery length. With or without medical therapies, people are getting better within two weeks after the first symptoms, and some are also recovering to their facial functions within six months.


Goldberg, J. M., & Harte, S. (1972). Emotional factors contributing to facial paralysis. Journal

Of Geriatrics Sociology. Vol 7, p.324-329. Wiley Online Library.

Greco, A., Gallo, M., Marinelli, C., Macro, G. F., & De Vincentiis, M. (2012). Bell’s Palsy and

autoimmunity. Autoimmunity Reviews, 12(2), 323-328. Retrieved from

Kheirkhah, M., Brodoehl, S., Leistritz, L., Götz, T., Baumbach, P., Huonker, R., Witte, O. W.,

Volk, G. F., Guntinas-Lichius, O., & Klingner, C. M. (2020). Abnormal emotional processing and emotional experience in patients with peripheral facial nerve paralysis: A MEG study. Brain Sciences (2076-3425), 10(3), 147. Retrieved from

Song, W., Cao, Z., Lang, C., Dai, M., Xuan, L., Lv, K., Cui, F., Jorgenson, K., Xu, M., &Kong, J. (2017). Disrupted functional connectivity of striatal sub-regions in Bell’s Palsy patients. Neuroimage: Clinical,14©, 122-129. Retrieved from

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