Joel Embiid, a center for the Philadelphia 76ers, recently announced that he has Bell’s palsy, a neurologic condition in which the nerve that controls facial muscles is damaged, resulting in facial weakness or temporary paralysis usually on one side of the face. Common symptoms include a lopsided smile and facial droop, an eyelid that won’t fully close, drooling, eye dryness, headache, ear pain, ringing in the ear, loss of the sense of taste, and sensitivity to sound.
For a professional basketball player like Embiid, not being able to close an eye could negatively affect performance. “Protecting your eyes by reflexively and rapidly closing them is especially important on the basketball court where the action happens so quickly,” says Gary Gronseth, MD, FAAN, chair of the neurology department at the University of Kansas Medical Center in Kansas City.
Eighty percent of people with Bell’s palsy fully recover and show no symptoms within three months without treatment so the condition is unlikely to affect Embiid’s career in the long run, says Dr. Gronseth. The chance of recovery increases to 95 percent with early treatment with steroids. The biggest indicator that symptoms may persist is the degree of facial weakness at the onset. In those cases, doctors may recommend eye drops if the eye is irritated and an eye patch to prevent infection and injury if the eye doesn’t close.
About 1 in 60 people will experience Bell’s palsy in their lifetime. The condition typically comes on suddenly and symptoms are most intense in the first 48 to 72 hours. It usually begins to resolve in a few weeks. In a few cases, symptoms can linger for months or even years as it did for the Tony-nominated playwright Sarah Ruhl.
“The cause of Bell’s palsy remains unknown in most patients but there is increasing evidence that in many cases it is caused by inflammation of the facial nerve from a virus such as Herpes simplex,” says Dr. Gronseth.
Because the symptoms of Bell’s palsy can resemble a stroke, it’s important to seek medical attention immediately. In most cases extensive testing is not needed but to exclude other conditions such as Lyme disease, middle ear infections, multiple sclerosis (MS), and tumors near the facial nerve, doctors may order tests including bloodwork to check for Lyme or sarcoidosis, an inflammatory disease that can affect organ function; an electromyogram to measure nerve activity and damage; a CT or MRI scan to look for a stroke, tumor, MS, or other causes of nerve damage; or even a spinal tap to check for meningitis, Lyme, or sarcoidosis.
Risk factors for Bell’s palsy include obesity, high blood pressure, diabetes, upper respiratory infection, and pregnancy, especially in the third trimester or the first week post-delivery.
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