{"id":17121,"date":"2010-09-08T09:48:13","date_gmt":"2010-09-08T13:48:13","guid":{"rendered":"http:\/\/dominicanewsonline.com\/dno\/?p=17121"},"modified":"2010-09-08T09:48:41","modified_gmt":"2010-09-08T13:48:41","slug":"health-talk-bells-palsy","status":"publish","type":"post","link":"https:\/\/dominicanewsonline.com\/news\/homepage\/columns\/health-talk\/health-talk-bells-palsy\/","title":{"rendered":"HEALTH TALK: Bell’s Palsy"},"content":{"rendered":"

\"\"INTRODUCTION<\/strong><\/p>\n

In deciding what to write about this week, my mind wandered onto a sweet old lady whom I diagnosed with this condition two weeks ago.\u00a0 For all the world, one would have thought she had a stroke, because her face was drawn to one side.\u00a0 But this was the clincher; only her face was involved, not a whole half of her body, as would be the case if it were a stroke.<\/p>\n

So this is what Bell\u2019s palsy is, a weakness or paralysis of the muscles that control expression on one side of your face.\u00a0 It results from damage to the Facial Nerve (Cranial nerve 7), which runs beneath each ear to the muscles on the same side of your face.<\/p>\n

It may result in a droopy appearance of your face, which can affect your self-esteem.\u00a0 Usually it is not serious and clears up by itself in weeks or months for most people.<\/p>\n

It is a condition which is actually relatively common in Dominica; many of you would have known someone who has had it.\u00a0 Bell\u2019s can occur at any age.\u00a0 It is seen more often in pregnant women, diabetics, people with ailments of the upper respiratory tract, such as the cold or flu, and in people with compromised immune systems, such as in HIV\/AIDS.<\/p>\n

HOW DO WE KNOW IT\u2019S BELL\u2019S?<\/strong><\/p>\n

Signs and symptoms may include:<\/p>\n

\u2022\u00a0\u00a0 \u00a0Acute paralysis or weakness on one side of your face, making it difficult to close one eye (on the affected side)
\n\u2022\u00a0\u00a0 \u00a0Drooping of the face and difficulty with facial expressions
\n\u2022\u00a0\u00a0 \u00a0Pain behind or in front of your ear on the affected side
\n\u2022\u00a0\u00a0 \u00a0Headache
\n\u2022\u00a0\u00a0 \u00a0Sounds that seem louder on the affected side
\n\u2022\u00a0\u00a0 \u00a0Loss of taste on the front potion of your tongue
\n\u2022\u00a0\u00a0 \u00a0Facial stiffness or a feeling that your face is being pulled to one side.\u00a0 Actually, in effect, your strong side does pull the weak side toward it.\u00a0 In other words, if your right side is affected, it will appear that your face is drawn to the left side.
\n\u2022\u00a0\u00a0 \u00a0Changes in the amount of tears and saliva you produce<\/p>\n

The severity of Bell\u2019s palsy can range from mild weakness to total paralysis on one side of the face.\u00a0 Onset is usually abrupt, developing to become apparent within several hours to a day or two.\u00a0 Symptoms may be noticed when you awaken.\u00a0 The palsy may follow pain in the region of the ear by a day or two.\u00a0 Weakness or paralysis usually peaks within 48 hours after onset of signs and symptoms, and the faster these signs and symptoms progress, the more serious the palsy you\u2019ll experience.
\n
\nWHAT CAUSES THIS THING?<\/strong><\/p>\n

Honestly, we don\u2019t know.\u00a0 And its development is still not well understood.\u00a0 The theory we most believe is that the facial nerve becomes swollen and injured perhaps by a viral infection.\u00a0 And the virus that has been implicated most often is of the herpes class.\u00a0 Yes, Herpes virus again.\u00a0 Remember chicken pox, shingles, cold sores?<\/p>\n

Each facial nerve controls all muscles on one side of your face, except those involved in chewing.\u00a0 The trigeminal (Cranial nerve 5), motor aspect, is responsible for this. That\u2019s why you can still chew just fine when you have Bell\u2019s.\u00a0 When electrical impulses cannot be properly conducted along the damaged facial nerve, the muscles which it supplies cannot be stimulated, leading to weakness or paralysis of these muscles.
\n
\nWHEN TO CHECK OUT THE DOC<\/strong><\/p>\n

Most people recover completely within weeks to months, with or without medical treatment.\u00a0 But not all cases of facial paralysis or weakness are due to Bell\u2019s palsy.<\/p>\n

For a few people, the palsy can be severe or give rise to complications.\u00a0 So see a doc if you have facial weakness, drooping or paralysis, to determine the severity and the underlying cause of your illness.
\n
\nHOW IS BELL\u2019S DIAGNOSED?<\/strong><\/p>\n

By looking at your face and asking you to try to move you facial muscles, the doctor can make a diagnosis.\u00a0 He will bear in mind, though, that stroke, infections and tumors can also cause muscle weakness, so he\u2019ll want to do a full examination and do tests to rule out other possible causes.<\/p>\n

If the diagnosis is still in doubt after a few days, a test called electromyography (EMG) can confirm the presence of nerve damage and give us information about severity.\u00a0 This is an out-patient procedure which can measure:<\/p>\n

\u2022\u00a0\u00a0 \u00a0The electrical activity of a muscle in response to stimulation.
\n\u2022\u00a0\u00a0 \u00a0The nature and speed of the conduction of electrical impulses along a nerve.<\/p>\n

To measure electrical currents in your facial muscles, tiny needles are inserted into a muscle to be tested.\u00a0 The needles are connected to an electronic recording device by a wire.\u00a0 Recordings of electrical activity are made when your muscle is at rest, and as you voluntarily tighten it.\u00a0 The patterns of activity appear on a screen and may be recorded on film for further analysis.<\/p>\n

To study your nerves, two small recording electrodes are taped on to your skin above the nerve to be tested.\u00a0 We can\u2019t see them, but we know where they are or should be.\u00a0 Then a little instrument applies a mild shock over the nerve.\u00a0 The electrical signal moves down the nerve, passing under the electrode.\u00a0 We can compare the recording of the signal at each electrode site, and we can calculate the time it takes to travel between them.\u00a0 The speed of conduction along the nerve is thus determined.<\/p>\n

By these tests on your facial nerves, we can determine whether and how much they are damaged, and by testing your facial muscle, we can tell how well they are receiving electrical impulses from these same nerves.\u00a0 Electricians and technical people should have no trouble understanding this bit.\u00a0 If you don\u2019t, don\u2019t worry about it.\u00a0 The doctors will have it under control.<\/p>\n

COMPLICATIONS<\/strong><\/p>\n

If damage to your facial nerve is unusually severe, nerve fibers may be irreversibly damaged, leaving you with a permanent paralysis.<\/p>\n

Sometimes misdirected re-growth of nerve fibers can occur, leading to involuntary contractions of certain muscles when you\u2019re trying to move others.\u00a0 For example, you may be smiling, only to find your eye on the affected side may close.<\/p>\n

HOW BELL\u2019S TREATED?<\/strong><\/p>\n

Well, we don\u2019t really know the cause, so we can\u2019t treat what we don\u2019t know.\u00a0 It\u2019s not like when we know, for example, the bacteria that infects your tonsils and can easily treat that.\u00a0 Besides, most cases are not going to last very long, and yet still we are not sure that what we do makes a difference.<\/p>\n

But we may try:
\nAnti-inflammatory medication:<\/strong> These may reduce inflammation and swelling in the bony channel that the facial nerve travels through.<\/p>\n

If we feel strongly that a virus is causative, such as the herpes virus, we may give an antiviral drug which can control, not cure it.\u00a0 Remember.
\n
\nMassage:<\/strong> Facial massage may help prevent disfigurements (contractures) of the paralysed muscles before recovery takes place.
\n
\nCAN YOU HELP YOURSELF?<\/strong><\/p>\n

Yes, you can.\u00a0 Because you cannot blink on the weak side of your face, damage to the outer layer (cornea) of your eye can occur due to it drying out.\u00a0 It can become cloudy and even develop an ulcer; which can interfere with vision.\u00a0 You will need to protect your eye using artificial tears, an eye patch, or a transparent eye shield attached to your face with tape.<\/p>\n

See you next week.<\/p>\n

Dr. Victor Emanuel has been an educator of medical professionals in training, and the public, for over 20 years in Dominica. The contents of his articles are based on facts and research conducted, and not of his opinion.<\/strong><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"INTRODUCTION In deciding what to write about this week, my mind wandered onto a sweet old lady whom I diagnosed with this condition two weeks ago.\u00a0 For all the world, one would have thought she had a stroke, because her…","protected":false},"author":15,"featured_media":17122,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_cbd_carousel_blocks":"[]","footnotes":""},"categories":[49],"tags":[],"class_list":["post-17121","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-talk"],"acf":[],"yoast_head":"\nHEALTH TALK: Bell's Palsy - Dominica News Online<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/dominicanewsonline.com\/news\/homepage\/columns\/health-talk\/health-talk-bells-palsy\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"HEALTH TALK: Bell's Palsy - 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