Angelina Jolie is a woman who is not afraid to speak openly about her health. In 2013, Jolie underwent a double mastectomy and reconstructive surgery after testing positive for the BRCA1 gene, mutations of the gene increase a woman's lifetime risk for developing breast and ovarian cancer. In March 2015, she had her ovaries and fallopian tubes removed.
"Sometimes women in families put themselves last, until it manifests itself in their own health," she told the magazine.
The National Institute of Neurological Disorders and Stroke defines Bell's palsy as a form of temporary facial paralysis resulting from damage or trauma to the facial nerves. Bell's palsy affects the function of the facial nerve, causing an interruption in the messages the brain sends to the muscles in the face, leading to weakness or paralysis in the area.
According to Dr. Matthew Hirsch, a facial plastic and reconstructive surgeon at New York Eye and Ear Infirmary of Mount Sinai, it almost always occurs on one side of the face, but can happen on both.
"It's not uncommon, and is more common in those who are 15 to 40 years old," Hirsch said. The National Institute of Neurological Disorders and Stroke reports that it afflicts approximately 40,000 Americans each year.
Hirsch noted that while trauma to the face, surgeries and ear infections can result in facial weakness, they wouldn't cause Bell's palsy. The condition is medically defined as a weakness of the face without an identifiable cause. Most in the medical profession believe that a virus causes it, but that has not been proven.
"Bell's palsy refers to a specific scenario where the patient experiences a fairly rapid onset of weakness of both the upper and lower face, without any identifiable cause. This frequently occurs within 72 hours," Hirsch explained.
Most people think they've had a stroke, he added.
Patients should visit a doctor as soon as they recognize the weakness or paralysis. Prescribed treatment is typically oral steroids and anti-viral medications, which greatly increase the odds of a full recovery.
Even without treatment, up to two-thirds of people will have a normal return to function.
"It can take six months to a year for the nerve to recover as much as it's going to recover," Hirsch said.
Hirsch said there are a lot of options for people with an incomplete recovery, including:
- physical therapy
- surgical options, ranging from small procedures to bring symmetry to the resting face, to bigger surgeries where nerve grafts are taken from other parts of the body, and muscle transfers, to make the mouth move again.
Jolie told Vanity Fair that she has recovered from the condition, thanks to acupuncture, although Hirsch said there's not enough evidence to recommend the treatment, "one way or another."
"A lot of my patients have already had acupuncture done. (Their) opinion is mixed," Hirsch said.
There is one crucial piece of advice for patients with an incomplete recovery, or those who have had a full recovery, but still have issues with their facial functions: See a specialist.
"If they are diagnosed with it, or not given a clear diagnosis, I'd recommend seeing someone who specializes in this condition (like a facial plastic surgeon) to receive appropriate treatment and management," Hirsch warned, stressing that a lot of doctors are unaware of all the options for patients.