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For Whom the Bell's Palsy Tolls

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

Article printed on page BM&S10, in the October 15-16, 2005 issue of
The Mississauga News under the feature: Health & Wellness, Medical Matters.

Bell's Palsy is a paralyzing condition that affects muscles on one side of the face. As often is the case, it is named after the first doctor who described it. In this case, it was a Scottish surgeon. One day, you may suddenly wake up with a feeling of tingling, tearing and mild pain limited to one side of your face. The muscle paralysis usually develops quickly, within 48 hours. The onset of Bell's Palsy has been correlated with respiratory illnesses, advanced age and diabetes. The immune system clearly plays a large role. Despite urban legends, it is not contagious, and affects the left side as frequently as it does the right side. Sometimes, I see patients with upper back and neck pains which a day later progress to Bell's Palsy. There is a growing body of evidence to suggest that a virus may cause Bell's Palsy. Herpes Simplex Type 1, found in those pesky cold sores has long been suspected. It is a very common infection that is easily acquired early in our lives. After the initial cold sore and flu symptom stage is over, it may enter a dormant stage and quietly exist at the base of your facial nerve. At a later time, the immune system may, for whatever reasons, allow it to reactivate. It then may cause swelling and inflammation within the nerve canal which result in symptoms of Bell's Palsy. The inflammation is generally of short duration, explaining why more than half of those afflicted recover fairly quickly. Most of the remaining patients will recover within a year depending largely on how well the nerve can regenerate itself. In a small portion of patients, the facial muscle paralysis may be permanent, as illustrated in a well-known Canadian prime minister.

Allowing our immune systems to deal with these conditions seems to be as good as any treatment that we have for them. Generally, we treat symptoms by providing analgesics for pain, drops to keep the eyes lubricated and tissues to soak up the drool. There is a place and time to use steroid medications, antiviral drugs and even surgery, but the choice is often difficult to make. The best advice is to take it seriously, drink plenty of fluids, eat well and rest to maximize your immune response. Stay away from products that claim to do this for you.

Related resources:

Bell's Palsy Information Site. Color illustrations. Contents include: Bell's Palsy FAQs (Bell's palsy is named for Sir Charles Bell, a 19th century Scottish surgeon who was the first to describe the condition), Facial Nerve, Facial Muscles, Causes of Facial Palsy, Ramsey Hunt Syndrome, Symptoms, Residual Effects, Treatment, Eye Protection, Facial Exercises, Botox for Residuals, Surgical Options, Facial Retraining, Treatment Centers (in U.S.A., Canada, Europe, Australia, Saudi Arabia, India), Chat Room, Links, Facial Paralysis Forums.
Bell's Palsy. Common causes, symptoms and treatment. Illustrated. From BUPA.co.uk (British United Provident Association - an international health and care company).
A Guide to Coping with Facial Paralysis. Link from Bell's Palsy Information Site.
Bell's Palsy from Merck Manual, Second Home Edition. Symptoms, Diagnosis, Treatment and Prognosis,
NINDS Bell's Palsy Information Page from National Institute of Neurological Disorders and Stroke, condensed from Bell's Palsy Fact Sheet. Contents include: What is Bell's Palsy? Is there any treatment? What is the prognosis? What research is being done? Organizations, Related NINDS Publications and Information, Additional resources from MEDLINEplus.
Bell's Palsy by Mayo Clinic staff. Contents: Overview, Signs and symptoms, Causes, When to seek medical advice, Screening and diagnosis, Complications, Treatment, Self-care.
Bell's Palsy - Also referred to as: 7th Nerve Palsy from EyeMDLink.com.
Bell's Palsy - Interactive Tutorial. Published by Patient Education Institute and licensed by National Library of Medicine.
Bell Palsy from eMedicine, by Michael Lambert, MD. Background, Pathophysiology, Anatomy, Pathway, Frequency (in U.S. & Internationally), Race, Sex, Age, History, Physical, Causes, Other Problems to be Considered, Lab Studies, Imaging Studies, Other Tests, Treatment: Emergency Department Care, Consultations, Medication, Drug Category: Corticosteroids, Drug Category: Antiviral, In/Out Patient Meds, Complications, Prognosis, Patient Education.
Bell's Palsy.
Bell's Palsy in Children, Bell's Palsy in Teens from KidsHealth.org. See also Neurologic Manifestations - Picture Gallery.
Bells Palsy Links from Hardin MD, University of Iowa.

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