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Two of my friends had Bell's palsy. Both recovered completely, but they still remember it as a very bad experience. In this condition, the muscles on one side of the face are weakened or even paralyzed. The eyelid muscles are unable to close the eye completely, so the patient has to “manually” blink during the day and tape the eye closed for sleeping. Eating is a challenge, and social interaction is impaired.
The exact cause of the condition is unknown. Inflammation of the facial nerve is a generally accepted reason for the muscle weakness. Both viral infections and autoimmune disease are under suspicion. The recent medical literature reports that 70 to 75 percent of cases clear up spontaneously, but the remaining patients may experience complications including prolonged weakness or even complete paralysis of facial muscles.
Maxillofacial surgeons may treat Bell's palsy with xylocaine nerve blocks plus vitamins, anti-viral drugs, and anti-edema medication, according to Reference 1. Neurologists generally use corticosteroids to reduce inflammation of the facial nerve.
Anti-viral drugs are a controversial treatment. Herpes simplex virus type 1 has been suggested as a possible cause of the nerve inflammation. A recent review reported that of three meta-analysis papers, one reported some benefit from anti-viral drugs, and two reported no benefit from them.
Acupuncture is another controversial treatment. A recent review concluded that published data are inadequate for judging its effectiveness, and more research is needed.
A research team in Taiwan studied the degree of nerve involvement in early Bell's palsy by electroneurography. Previous studies, they report, have shown that poor scores on this test correlate with long-term symptoms. The researchers found average scores get worse with age, but better with use of corticosteroids. Thus, corticosteroids should be considered early in the course of the illness, especially in older patients.
References:
1. Bejtovic B et al, “Comparative advantages and shortcomings of cortisosteroids in comparison with xylocaine-based perineural blocks in treatment of Bell's palsy”, Med Arh. 2009; 63(4): 225-7.
2. Kennedy PG, “Herpes simplex virus type 1 and Bell's palsy – a current assessment of the controversy”, J Neurovirol. 2010 Feb; 16(1): 1-5.
3. Langer-Gould A et al, “Autoimmune diseases prior to the diagnosis of multiple sclerosis: a population-based case-control study”, Mult Scler. 2010 Jul; 16(7): 855-61.
4. Chen N et al, “Acupuncture for Bell's palsy”, Cochrane Database Syst Rev. 2010 Aug 4; 8: CD002914.
5. Ru-Lan H et al, “Correlates of degree of nerve involvement in early Bell's palsy”, BMC Neurology 2009; 9:22.
Linda Fugate is a scientist and writer in Austin, Texas. She has a Ph.D. in Physics and an M.S. in Macromolecular Science and Engineering. Her background includes academic and industrial research in materials science. She currently writes song lyrics and health articles.
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Linda - A co-worker developed this several years ago, and had the same concerns as your Facebook friend. He also recovered, but it was a difficult experience. Thanks for this article, it was good to see this topic on EmpowHER.
December 10, 2010 - 4:24pmPat
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Here's a comment I got on Facebook: "As one who has had Bell's Palsy, I just found it annoying. Blinking the eye manually and taping it shut at night was no big deal, but eating was a challenge. Had a tendency to chew on my lip (because I couldn't feel it), and soups & liquids were a dribbling mess. I recovered fully; my doctor treated me with corticosteroids."
December 10, 2010 - 3:43pmThis Comment
I fell victim to Bell's Palsy in September 2010. I'm still suffering from it today. It has created difficulties in my speaking, eating, sight, and facial emotions.
December 10, 2010 - 3:12pmThe doctors told me that after I take the antiviral drugs and steroids, there is nothing more that can be done. The condition will wear off in time. Patience is a virtue, but...
I need help dealing with it. Please let me know if any unconventional treatments have worked; or, if you know of anything that will work. Thanks.
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