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Bell's Palsy
The sudden
appearance of facial asymmetry associated with inability to
close the eye and disappearance of the creases on the forehead
on the affected side are enough to scare anyone. The first
thought, of course is that the person may have had a stroke.
Stroke can mimic these symptoms, but the last two features
detailed above illustrate weakness of the muscles of the upper
face, and are strongly suggestive of a peripheral nerve (facial
nerve) problem rather than a central nervous system problem like
a stroke, which can affect the lower facial muscles. The most
common cause of one sided facial weakness is Bells’ palsy. We
are not sure yet what causes this sudden onset of muscular
paralysis, but we do know that there is swelling of the facial
nerve at a point in its course that creates a compression effect
that is the immediate reason for the symptoms.
I have seen
numerous cases of Bell’s palsy which appeared to be triggered
after exposure to a cold or cool breeze, like an automobile air
conditioner blowing on someone during a long road trip, or a fan
directed at a person’s face. Surprisingly, the most common
infection associated with Bell’s palsy is herpes virus type 1.
The virus has been cultured from fluid taken from around the
nerve during decompression surgery. Since we know that the
herpes virus “hides” within cells of the nervous system, the
thinking is that a reactivation of the latent virus by some
stimulus impinging on the immune system is the cause of the
condition in most patients. Lyme’s disease is also associated
with the onset of Bell's palsy, and may act as a reactivation
trigger. Thus anyone who has suffered with Bell’s palsy in the
past should probably be tested for Lyme’s disease.
Although a
short course of steroid medication can be helpful in reducing
the duration of the usually self limited symptoms, there can be
potential side effects, and steroids have an immunosuppressive
effect. That is not a good thing in someone who just had a
reactivation of a latent viral infection due to some assault on
his immune system. I have had good results with daily vitamin
B12 injections given at home, along with AMP. The B12 supports the
nerve tissue while AMP has antiviral effects. Intravenous DMSO
also helps because of its powerful effect in reducing tissue
swelling. Oral antiviral drugs like acyclovir are probably worth
trying. There is a therapeutic window of about two weeks before
the compression causes permanent nerve damage. Fortunately
nearly 90% of cases (with treatment) will recover completely.
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