{"id":8431,"date":"2014-04-17T10:03:02","date_gmt":"2014-04-17T14:03:02","guid":{"rendered":"http:\/\/ianchadwick.com\/blog\/?p=8431"},"modified":"2014-04-17T10:03:02","modified_gmt":"2014-04-17T14:03:02","slug":"what-do-we-know-about-bells-palsy","status":"publish","type":"post","link":"https:\/\/ianchadwick.com\/blog\/what-do-we-know-about-bells-palsy\/","title":{"rendered":"What do we know about Bell’s Palsy?"},"content":{"rendered":"
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\"Bell's<\/a>Bell’s Palsy is one of those rare ailments,<\/strong> and one that annoys more than threatens, but can be difficult and socially awkward for sufferers. It’s also one that still baffles researchers as to its cause. And also for an effective treatment.<\/p>\n

According to facialpalsy.org<\/a>,<\/p>\n

The name \u2018Bell’s palsy\u2019 comes from 19th-century Scottish anatomist and surgeon Sir Charles Bell, who discovered that severing the seventh cranial (or facial) nerve causes facial paralysis.<\/p><\/blockquote>\n

It has no vaccine, no known method for prevention, and the treatment is still uncertain.<\/p>\n

[youtube=https:\/\/www.youtube.com\/watch?v=zxVHFJs1uJ4]<\/p>\n

Wikipedia<\/a> tells us:<\/p>\n

Bell’s palsy is a form of facial paralysis resulting from a dysfunction of the cranial nerve VII (the facial nerve) causing an inability to control facial muscles on the affected side… Bell’s palsy is the most common acute mononeuropathy (disease involving only one nerve) and is the most common cause of acute facial nerve paralysis (>80%)… The hallmark of this condition is a rapid onset of partial or complete paralysis that often occurs overnight.<\/p><\/blockquote>\n

It also says:<\/p>\n

It is thought that an inflammatory condition leads to swelling of the facial nerve. The nerve travels through the skull in a narrow bone canal beneath the ear. Nerve swelling and compression in the narrow bone canal are thought to lead to nerve inhibition, damage or death…
\nSome viruses are thought to establish a persistent (or latent) infection without symptoms… Reactivation of an existing (dormant) viral infection has been suggested as a cause of acute Bell’s palsy. Studies suggest that this new activation could be preceded by trauma, environmental factors, and metabolic or emotional disorders, thus suggesting that a host of different conditions may trigger reactivation.<\/p><\/blockquote>\n

Which, in essence, doesn’t tell us a lot about the actual cause or why it recurs; mostly it remains guesswork. Bell’s Palsy\u00a0affects about 20 people per 100,000 population, and the incidence increases with age and with certain medical conditions.<\/p>\n

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The National Institute of Neurological Disorders and Stroke<\/a> says somewhat more comprehensively:<\/p>\n

Bell’s palsy occurs when the nerve that controls the facial muscles is swollen, inflamed, or compressed, resulting in facial weakness or paralysis. Exactly what causes this damage, however, is unknown.\u00a0Most scientists believe that a viral infection such as viral meningitis or the common cold sore virus\u2014herpes simplex\u2014causes the disorder. They believe that the facial nerve swells and becomes inflamed in reaction to the infection, causing pressure within the Fallopian canal and leading to ischemia (the restriction of blood and oxygen to the nerve cells). In some mild cases (where recovery is rapid), there is damage only to the myelin sheath of the nerve. The myelin sheath is the fatty covering-which acts as an insulator-on nerve fibers in the brain.<\/p>\n

The disorder has also been associated with influenza or a flu-like illness, headaches, chronic middle ear infection, high blood pressure, diabetes, sarcoidosis, tumors, Lyme disease, and trauma such as skull fracture or facial injury.<\/p><\/blockquote>\n

It notes the treatment is relatively simple, albeit takes time:<\/p>\n

Recent studies have shown that steroids such as the steroid prednisone — used to reduce inflammation and swelling –are effective in treating Bell’s palsy.<\/p><\/blockquote>\n

Steroids have to be started as quickly as possible after onset, however, to be effective, as this study<\/a> shows.<\/p>\n

Other drugs such as acyclovir — used to fight viral herpes infections — may also have some benefit in shortening the course of the disease. Analgesics such as aspirin, acetaminophen, or ibuprofen may relieve pain…<\/p><\/blockquote>\n

However, as the BMJ site<\/a> notes, antivirals are most effective when used within 72 hours of onset – along with the steroids. Anti-viral medicine “enhances” recovery rates when paired, but alone seems to have no significant effect.<\/p>\n

The prognosis for individuals with Bell’s palsy is generally very good. The extent of nerve damage determines the extent of recovery. Improvement is gradual and recovery times vary. With or without treatment, most individuals begin to get better within 2 weeks after the initial onset of symptoms and most recover completely, returning to normal function within 3 to 6 months. For some, however, the symptoms may last longer. In a few cases, the symptoms may never completely disappear. In rare cases, the disorder may recur, either on the same or the opposite side of the face.<\/p><\/blockquote>\n

Blocking pain is helpful, because pain may also happen as a side-effect of the anti-viral drugs (headache in particular). There are often side effects from the prescribed drugs for Bell’s Palsy, as Medical News Today<\/a> tells us.\u00a0Most of these are minor, but there is one serious potential side-effect from the ailment every sufferer needs to pay attention to :<\/p>\n

Eye lubrication<\/strong> – if the patient is not blinking properly the eye will be exposed and tears will evaporate. Some patients will experience a reduction in tear production. Both may increase the risk of damage or infection. The doctor will prescribe artificial tears in the form of eye drops and also an ointment. The eye drops are usually taken during the waking hours, while the ointment is applied before going to sleep.<\/p>\n

Patients who cannot close their eye properly during sleep will need to use surgical tape to keep it shut. Patients who experience worsening eye symptoms should seek medical help immediately. If you cannot get hold of your doctor go the emergency department of your nearest hospital.<\/p><\/blockquote>\n

The Mayo Clinic<\/a> adds:<\/p>\n

Bell’s palsy, also known as facial palsy, can occur at any age. The exact cause is unknown, but it’s believed to be the result of swelling and inflammation of the nerve that controls the muscles on one side of your face. It may be a reaction that occurs after a viral infection.<\/p>\n

For most people, Bell’s palsy is temporary. Symptoms usually start to improve within a few weeks, with complete recovery in about six months. A small number of people continue to have some Bell’s palsy symptoms for life. Rarely, Bell’s palsy can recur.<\/p><\/blockquote>\n

But recur, it can. Why it does\u00a0is another guessing game. The clinic lists several potential viral causes, all of which might play a role in recurrence:<\/p>\n

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