From the Guidelines
The forehead is indeed affected in Bell's palsy, as the condition involves weakness or paralysis of the facial nerve (cranial nerve VII) that typically affects one side of the face, including the forehead muscles. In Bell's palsy, patients cannot wrinkle their forehead, raise their eyebrow, or close their eye completely on the affected side, due to the involvement of the facial nerve after it exits the brainstem, impacting all branches of the nerve including those that supply the frontalis muscle of the forehead 1. This is a key diagnostic feature that helps distinguish it from central causes of facial weakness, where the forehead is usually spared due to bilateral cortical innervation of the upper face. Some key points to consider in Bell's palsy include:
- The condition typically develops suddenly over 24-48 hours and may be accompanied by other symptoms like pain around the ear, altered taste, and increased sensitivity to sound on the affected side 1.
- Most cases resolve spontaneously within 3-6 months, though some patients may have residual weakness, and treatment with steroids can hasten recovery 1.
- The facial nerve (CN VII) is a complex nerve that contains branchial motor, visceral motor, general sensory, and special sensory functions, and its paralysis can result from various pathologies affecting the nerve or its nucleus 1.
From the Research
Effects of Bell's Palsy on the Forehead
- Bell's palsy affects the seventh cranial nerve, leading to unilateral facial weakness, which includes reduced forehead wrinkling 2.
- The presentation of Bell's palsy is characterized by a lack of forehead movement, among other symptoms such as nasolabial fold flattening and drooping of the corner of the mouth 2.
- The condition can cause physical and psychological complications, and its effects on the forehead are part of the broader impact on facial muscle paresis or complete paralysis 3.
Treatment and Recovery
- While the forehead is affected in Bell's palsy, treatment with corticosteroids and antiviral agents can help improve recovery outcomes 4, 5, 6.
- Corticosteroids are widely used in the treatment of Bell's palsy, and their effectiveness in reducing the risk of unsatisfactory recovery has been demonstrated 6.
- The combination of antivirals and corticosteroids may have additional benefits in reducing the risk of incomplete recovery and long-term sequelae, although the evidence is not always consistent 4, 5.