Thousands of patients with facial paralysis have remained deformed for life because doctors could not recognize it
As a trained army sniper in top condition, Marcus Horton was immediately ready for action in a war zone.
But nothing could have prepared him for the painful struggle he faced after waking up one morning in January 2017 to discover that the entire right side of his face had completely collapsed, making him drooling, speechless and unable to close his right eye to close.
“I was terrified that I had had a stroke,” says Marcus, 31, who was serving with the Royal Welsh Regiment at the time.
His fast-thinking fiancé, Hannah, immediately searched for his symptoms online and found a perfect match: Bell’s parese.
Marcus Horton is pictured on the left before he was bothered by Bell’s parese. And he is immediately shown
The surprisingly common condition occurs when the cranial nerve that controls the muscles on one side of the face becomes inflamed. This prevents it from sending signals to the muscles around the eyes, nose, mouth, cheeks and forehead, causing the half face to become paralyzed.
It can affect anyone: Hollywood stars Pierce Brosnan, George Clooney and Angelina Jolie are among those who have had it and have recovered.
Bell’s parese affects at least 25,000 people a year in the UK – the equivalent of nearly 70 every day – and is often caused by something as harmless as a cold.
Marcus was bedridden with flu just a few days earlier.
More than 70 percent of patients recover fully – as long as they are treated with high doses of anti-inflammatory steroid tablets within 72 hours of the onset of symptoms.
The drugs work by relieving the problematic swelling around the nerves in the face.
Seized by crippling depression, Marcus (pictured with Bell’s parese) was medically discharged from the army in October 2018, signifying the end of his dream career. He postponed his marriage to Hannah – too embarrassed that he would not be able to smile on the big day
But after that opportunity channel, the chance of full recovery decreases because the nerves and muscles can become so damaged that it is impossible to get them back to their full capacity, often leaving patients with a permanent deformation of the face that can ruin their lives.
When Marcus and Hannah reached the Salisbury General Hospital near where he was stationed, doctors initially rejected the couple’s suggestion of Bell’s paresis and tested for meningitis. “They have signed a complete blank,” says Marcus. “Then, five days after I was admitted, a specialist from Southampton came to visit me. The moment she walked through the door, she said I actually had Bell’s parese. “
It was a crushing blow, not least because Marcus had missed the vital opportunity to get the medication he needed.
In the next two years, he lost vision in his right eye – because he could not blink – and suffered hearing loss and vision pain due to nerve damage. He had to teach himself to speak again with the help of YouTube videos.
Seized by crippling depression, Marcus was medically discharged from the army in October 2018, signifying the end of his dream career. He postponed his marriage to Hannah – too embarrassed that he would not be able to smile on the big day.
“It felt like nobody could help me,” he says.
And it seems that Marcus is far from alone. In fact, thousands of Britons run the risk of being maimed for life because they ‘slip through the medical net’ – and don’t get the right treatment for facial paralysis.
Shocking new figures suggest that nearly one in five – equivalent to around 5,000 people in the UK each year – initially get an incorrect diagnosis, delaying their access to vital drugs for weeks or even months and reducing the risk of permanent visual damage increases. Two-thirds also waited more than a year to see a specialist, despite NHS guidelines that patients should be referred within three months.
How Bell’s paresis can affect your eating, speaking and blinking
- Bell’s parese can strike within a few minutes. It occurs when the cranial nerve that controls the muscles on one side of the face becomes inflamed. This prevents the nerve from sending signals to muscles around the eyes, nose, mouth, cheeks and forehead.
- Each side of the face has its own nerve and the condition usually affects only one side, usually the right side.
- Paralysis of the eyelid muscles can prevent blinking – and means that the affected eye must be glued shut at night. Eye drops are applied daily to prevent the eye from drying out. There may also be problems with eating, drinking, speaking and making expressions.
- The condition mainly occurs between ten and forty years and is more common during pregnancy and in people with diabetes.
- The rates are usually higher in the winter, when viruses such as those that cause cold sores and flu, circulate earlier.
According to the new study of more than 400 patients by the Facial Palsy UK charity, more than 40 percent of patients who asked for help felt that their GPs could not refer them for specialist treatment – because they did not know what was the right doctor to see them. The poll results support disruptive findings from a 2013 study in the British Medical Journal, which found that as many as 44 percent of UK Bell’s paralyzed patients did not receive urgent steroid treatment.
Mr. Bill Townley, a plastic surgeon consultant at Guy’s and St Thomas’ NHS Foundation Trust in London and an expert in the condition, says the underlying problem is that many doctors still view it as a purely cosmetic problem while in fact it is devastating physical and mental health effects.
Townley says, “There is no coherent strategy at the national level, meaning that hundreds, if not thousands, of patients per year have lifelong facial paralysis that could have been avoided with previous intervention by specialists.
“About two-thirds of those who are treated early with steroids will fully recover.”
He says that patients who do not respond to rapid steroid therapy can still recover, but this depends on receiving specialized physiotherapy in the first few months after becoming ill, when the nerves and muscles in the face are still partially working.
Karen Johnson, deputy CEO of Facial Palsy UK, says that special exercises can at least reverse some of the damage, even years later.
“The right kind of face training is crucial,” she says.
“If you suspect that you have Bell’s paralysis and your doctor hesitates to refer you to a therapist with experience in managing it, refer him or her to our website. Maybe you should insist. “
Marcus and Hannah finally got married in April 2018, despite his fear of his appearance on the big day.
He says, “I just want my story to help someone else with the paralysis of Bell get the early treatment they need to recover properly.”