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| English: Image of the cross facial nerve graft procedure in facial paralysis. (Photo credit: Wikipedia) |
by Dr. Gary S. Sy
BELL’s Palsy is a weakness or paralysis of the muscles that control expression on one side of the face. The disorder results from damage of one of a pair of facial nerves that runs beneath each ear to the muscle of the face.
The condition may result in a dropping appearance of the face. Most often Bell’s palsy isn’t serious. The problem can occur at any age. More often in pregnant women, in people with diabetes, upper respiratory ailments, such as flu or a cold, and in people with condition that compromise their immune system.
Bell’s Palsy clears up on its own within a week or months for most people.
Signs and symptoms:
* Sudden onset of paralysis or weakness on one side of your face, making it difficult to smile or close your eyes on the affected side.
* Facial droop and difficulty with facial expression.
* Facial stiffness or a feeling that your face is being puled to one side.
* Pain behind or in front of your ear on the affected side.
* Sound that seem louder on the affected side.
* Pain in the ear on the affected side.
* Headache
* Loss of taste on the front portion of your tongue.
* Changes in the amount of tears and saliva your body produces
The severity of Bell’s Palsy can range from mild weakness to total paralysis on the one side of the face. The onset of the problem is fairly abrupt, generally becoming apparent within several hours to a day or two. You may notice symptoms when you awaken. Pain in the vicinity of the ear can precede the palsy by a day or two. Weakness or paralysis usually peaks within 48 hours after onset of the signs and symptoms. The faster the signs and symptoms progress, the more serious the weakness or paralysis you’ll experience.
Causes:
Each facial nerve controls all muscle on one side of your face, except for the muscles involved in chewing. The cause of Bell’s palsy is still unclear. But many believe that a viral infection – perhaps most commonly by the herpes, simplex virus, the same virus, that causes cold sore – can cause the facial nerve to become swollen and injured. Impairment of electrical impulses directed to your facial muscles by the damaged nerve results in the weakness or paralysis of these muscles.
Complication:
Although a mild case of Bell’s Palsy normally disappears within a month, recovery from a case involving total paralysis. If the damage to your facial nerve is usually severe, the fibers may be irreversibly damaged. Another complication can arise from misdirected regrowth of the nerve fibers, which can result in involuntary contraction of a certain muscle when you’re trying to move others (synkinesis). For example, when you smile, the eye on the affected side may close.
Treatment:
* Anti-inflammatory medication
* Anti-viral medication
* Facial Massage
* Chemical injection
* Surgical Procedure (eyelid weighs or a spring, muscle transfer, nerve substitution)
* Facial retraining (Physical Therapy Treatment/rehabilitation)
Self-care
You’ll need to protect your eye from damage to its outer layer (cornea) because of the absence of blinking on the side of your face with weakness. An excessively dry eye result in clouding of the cornea, and may lead to corneal ulcer, which can interfere with your vision. You can protect your eye with artificial tears (special eye lubricant), an eye patch or a transparent eye shield.
(Dr. Gary S. Sy, MD is the Medical Director of Life Extension Medical Center located at The Garden Plaza Hotel (formerly Swiss Inn Hotel), 1370 General Luna St., Paco, Manila. He is a Diplomate in Gerontology and Geriatrics, advocates Diet-Nutritional therapy, and conducts free seminar every Friday about age-related health problems. For more details e-mail address lifeextension_drgarysy@yahoo.com. This e-mail address is being protected from spam bots, you need JavaScript enabled to view it Please tune in at DZRH 666 kHz "Operation Tulong" every Wednesday and Friday at 10 p.m.-11 p.m. and DZMM 630 kHz "Gabay sa Kalusugan" awarded as "2005 CMMA as Best Educational Radio Program," every Sunday at 10 a.m.-11 a.m.)
Source: Manila Bulletin
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. No readily identifiable cause for Bell's palsy has been found.
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