It was a terrifying moment for Mary King. On June 1, sitting on the runway in Charlotte, N.C., on a plane bound for Baltimore where she planned to celebrate her upcoming wedding with friends, the 25-year-old television reporter realized she couldn't rub her lips together. Then, she couldn't move the right side of her face or blink her right eye.
She paged the flight attendant for help, and a doctor on board the plane said King had better get to a hospital. The pilot took the plane back to the airport, and King's father rushed her to the nearest emergency room.
King feared she was having a stroke, but the doctor had an even more unexpected diagnosis: she had Bell's palsy.
When King finally looked at her face in the mirror at the hospital, she said she felt a wave of despair: The right side of it was frozen, her eye was unblinking and the side of her mouth drooped, even when she tried to smile.
"All of a sudden it hits you how different you look," she said. "I kept thinking, What if I still look like this on my wedding day?"
People with Bell's palsy aren't typically stricken for life, but recovery can take weeks to months. The condition, a temporary facial paralysis, strikes when the seventh cranial nerve, the tiny nerve controlling the face, gets inflamed or damaged, perhaps from some kind of trauma or viruses such as Epstein Barr or the varicella zoster virus, the virus that causes chicken pox and shingles.
"It's probably not the virus itself causing the symptoms, but the body's reaction to the virus, the inflammation that comes from fighting it off," said Dr. Wendy Wright, medical director of the NeuroIntensive Care Unit at Emory University Hospital Midtown in Atlanta. "But the exact cause of Bell's palsy isn't exactly known."
There are few symptoms that are red flags of a Bell's palsy attack. But looking back on the 12 hours before her diagnosis, King could see there were signs she had dismissed. When she awoke early that morning for her shift on the morning news for WIS TV, the NBC affiliate in Columbia, S.C., she had a sharp, shooting pain in the back of her head. Later, when she opened a carton of blueberry yogurt for breakfast, it was tasteless, like eating paste.
"Looking back with 20/20 hindsight, I could see, OK, that was the onset of the symptoms," King said. "But at the time, you just keep going."
Once the facial paralysis sets in, many people may mistake it as a symptom of a stroke, just as King did. Wright said neurologists are also thinking about the possibility of a stroke when a patient reports facial paralysis. But there are a few subtle differences. A stroke will usually cause a few additional symptoms, such as numbness or weakness in the arms and legs. And unlike Bell's palsy, a stroke will usually let patients control the upper part of their faces.
"I will ask patients to raise their eyebrows as if they are surprised," Wright said. "A person with a stroke will usually have some wrinkling of their forehead."
A week after her attack, King's symptoms still hadn't dissipated much. She still couldn't close her right eye, and had to sleep wearing an eye-patch to keep it closed so her cornea wouldn't dry out. Doctors gave her steroids and anti-inflammatory medications.
Embarrassed that she couldn't smile and interact normally with people, depression set in, as it does for many patients with Bell's palsy. King's job as a local television reporter made the stress of her paralyzed face even worse. She had to stop reporting on the air while she tried to recover.
"I love my job. I'm one of those people who loves getting up and going to work in the morning," King said. "The first thought that went through my mind was what if this doesn't go away and I can't do my job anymore?"
The hardest moment came when King went to try on wedding gowns with her mother. Standing in front of the mirror, all she could manage was a lopsided smile.
"I just didn't want to look in the mirror," she said. "All I wanted to do was smile because I was so happy, but when I did it just looked so awkward."
When she explained her condition and the fact that she couldn't smile to the women running the shop, someone replied, "You are smiling. You're smiling with your eyes."
Gradually, King started to improve. It was 15 days before she could smile again. Now, more than three weeks after those first terrifying moments on the plane, King said she is about 97 percent recovered. But she still notices little things.
"I used to be able to wink with both eyes, now I can't wink with the right eye," she said. "But I'm by no means complaining. To have my recovery time be what it was is a blessing."
Although most people recover from Bell's palsy, having one attack makes it more likely that another one will strike. And some people never recover.
King reported her experience for WIS TV, and said she was inspired by the outpouring of support from people in Columbia, many of whom had Bell's palsy themselves, or saw the condition strike friends and family. She said the most important thing that kept her going through her recovery was the community's support and a determined faith that she would get better.
"Really, the prayers and keeping the hope and believing in your heart that this will get better was the key," King said. "Perspective is everything."