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Understanding Bell’s palsy

During the past few month's I have had several patients come into my clinic who have be suffering from Bell's palsy, a condition that arises when there is damage to a facial nerve. The facial nerves a...

During the past few month’s I have had several patients come into my clinic who have be suffering from Bell’s palsy, a condition that arises when there is damage to a facial nerve. The facial nerves are responsible for the muscles of the face as well as taste sensation in the front of the tongue. In Bell’s palsy, one of the two facial nerves is damaged, compressed or inflamed which results in weakness of the facial muscles and causes the eyelid and corner of the mouth to droop on one side.

For many people experiencing these symptoms, their first reaction is that they are having a stroke. However, strokes are associated with muscle weakness and paralysis of muscles in other parts of the body as well as the face.

In order to understand the cause of Bell’s palsy it is important to look at the anatomy of the skull. The facial nerve passes through a narrow opening in the skull on its way to the face. If this nerve becomes swollen and enlarged it will get pinched in this tight corridor leading to a decrease in nerve flow to the face. This in turn causes muscle weakness and other symptoms. The most common causes of this condition are the herpes simplex and herpes zoster viruses. These are the viruses that are responsible for cold sores and chicken pox respectively. In rare cases, Bell’s palsy may be caused by a tumour called an acoustic neuroma. Other conditions such as being pregnant, having diabetes or an upper respiratory tract infection will also increase your risk of getting Bell’s palsy.

In most cases the symptoms will develop over 24 hours. The symptoms may include: sudden onset of paralysis or weakness of the muscles on one side of the face; pain behind the ear on the affected side of the face; headache; impairment of taste; facial droop and difficulty with facial expression; changes in the amount of saliva your body produces.

The diagnosis of Bell’s palsy is usually determined from the symptoms alone as there is no specific laboratory test to identify this condition. However, if your doctor suspects that a tumour is the cause, then he or she may arrange a CT scan or MRI. Nerve conduction tests are also used to determine the extent of nerve damage. Although most people with Bell’s palsy recover fully with or without treatment, your doctor may prescribe medications or physical therapy to help speed up your recovery. The most common medication prescribed for Bell’s palsy is corticosteroids such as prednisone. It helps reduce the swelling of the nerve. However, if the cause is a virus then an antiviral drug such as acyclovir may be prescribed to stop its progression. Massage and exercises are also helpful to prevent muscle wasting.

If your eye is affected, your doctor may recommend artificial tears and will probably advise you to tape your eye closed when you sleep to prevent permanent damage to the cornea of your eye. Interestingly, some people obtain good results from alternative therapies such as relaxation and acupuncture. Finally,

if all other treatments fail, decompression surgery is used to relieve the pressure on the facial nerve.

The prognosis of Bell’s palsy is usually very good. With appropriate treatment, symptoms will improve in about two weeks. However, it may take several months to achieve a full recovery. Bell’s palsy is not usually a serious condition however it does cause some discomfort.

-Dr. Chris Singh, B. Kin., D. C., runs Trans-Canada Chiropractic at 230 Truck Stop in Woodstock, Ont.

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