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The facial nerve controls most of the muscles in the face and parts of the ear. The facial nerve goes through a narrow gap of bone from the brain to the face. This nerve becomes inflamed.

We are not completely certain what the cause of Bell's palsy is. However, experts believe it is most likely caused by a virus, usually the herpes virus, which inflames the nerve. The herpes virus is the one that also causes cold sores and genital herpes. Other viruses have also been linked to Bell's palsy, including the chickenpox and shingles viruses, which are both related to the herpes virus. The virus that causes mononucleosis (Epstein-Barr) as well as the cytomegalovirus have also been linked to Bell's palsy. Lyme disease in areas where it is endemic may be a principal cause of Bell's palsy type symptoms caused by bacteria.

If the nerve is inflamed it will press against the cheekbone or may pinch in the tight corridor (narrow gap of bone) - this can result in damage to the protective covering of the nerve.

If the protective covering of the nerve becomes damaged, the signals which are being sent from the brain to the muscles in the face may not be transmitted properly, leading to weakened or paralyzed facial muscles - Bell's palsy.

trauma to the facial nerve may also result in bell's palsy.

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