Bell’s Palsy
Bell’s palsy is an acute, apparently isolated, lower motor neuron facial palsy for which no cause can be found.
The most common form of facial paralysis is Bell’s palsy. The annual incidence of this idiopathic disorder is ~25 per 100,000 annually, or about 1 in 60 persons in a lifetime. Risk factors include pregnancy and diabetes mellitus. a lower motor neuron lesion of the 7th (facial) nerve, affecting all ages and both sexes.
(a) known clinical conditions – Diabetes, severe hypertension, last trimester of pregnancy, dental anesthesia.
(b) Causes – Associated
(i) Firstly, Exposure to cold; oedema and subsequent compression of nerve trunk within the rigid fallopian canal causes circulatory disturbance.
(ii) Secondly, Other important causes of acute facial palsy include suppurativa otitis media, herpes zoster, head injury, Guillain-Barre syndrome, sarcoidosis and multiple sclerosis
- Family history of the disease
- Diabetes
- Autoimmune disorders
- Weakened immune system
- Infections
- Chemotherapy
- Pregnancy
- Certain medications
- Smoking
- Hypertension
Generally, In acute Bell’s palsy, there is inflammation of the facial nerve with mononuclear cells, consistent with an infectious or immune cause. Furthermore, Herpes simplex virus (HSV) type 1 DNA was frequently detected in endometrial fluid and posterior auricular muscle, suggesting that a reactivation of this virus in the geniculate ganglion may be responsible for most cases. Lastly, Reactivation of varicella-zoster virus is associated with Bell’s palsy in up to one-third of cases and may represent the second most frequent cause.
other viruses
In brief, A variety of other viruses have also been implicated less commonly. Additionally, an increased incidence of Bell’s palsy was also reported among recipients of inactivated intranasal influenza vaccine, and it was hypothesized that this could have resulted from the Escherichia coli enterotoxin used as adjuvant or reactivation of latent virus
- Sudden, following exposure to chill or without any apparent precipitating cause, maximum paralysis in 24 hours
- Moreover, Postauricular pain is common and may precede paralysis by 2 days
- Loss of sense of taste
- Hyperacusis also
- Watering of the eye
- Sweating less on affected side
Signs:
Forehead
- Forehead cannot be wrinkled; frowning lost (especially, frontalis).
Eye
- Eye cannot be closed (e.g. orbicularis oculi, sphincter of palpebral fissure). On attempting closure, eyeball turns upwards and outwards (in other words, Bell’s phenomena).
teeth
- On showing the teeth, the lips do not separate on affected side. Whistling not possible. Articulation of labial components difficult. Nasolabial fold flattened out. Angle of mouth on affected side droops with dribbling of saliva (in case of Orbicularis oris, sphincter of oral fissure).
Cheek
- Cheek puffs out with expiration because of buccinators paralysis. Food collects between teeth and paralysed cheek. Even Fluid runs out while drinking (specifically in buccinators).
tongue
- Base of tongue lowered (stylohyoid and posterior belly of digastric).
Vesicles within the external auditory meatus and ear drum in Ramsay Hunt syndrome. Pain may precede facial weakness. Deafness may result.
Physical examination of patients with Bell’s palsy is usually remarkable for: unintended eye closure with an effort to smile, incomplete closure and the of the eye when patient attempts to close the eyes, inability to puff the cheek in affected side and impaired or absent taste in affected side, reduced hearing acuity.
Electromyography – of prognostic importance:
(a) If signs of denervation after 10 days – Axonal degeneration, recovery either incomplete or delayed.
(b) If incomplete denervation in less than 7 days – Good prognosis.
(c)Fibrillation potential after 2 weeks suggests Wallerian degeneration.
There are many other causes of acute facial palsy that must consider in the differential diagnosis of Bell’s palsy. Lyme disease can cause unilateral or bilateral facial palsies; in endemic areas, 10% or more of cases of facial palsy are likely due to infection with Borrelia burgdorferi
Palsy is likely due to infection with Borrelia burgdorferi The Ramsay Hunt syndrome, cause by reactivation of herpes zoster in the geniculate ganglion, consists of a severe facial palsy associated with a vesicular eruption in the external auditory canal and sometimes in the pharynx and other parts of the cranial integument; often the eighth cranial nerve is affected as well.
Facial palsy that is often bilateral occurs in sarcoidosis. . Leprosy frequently involves the facial nerve, and facial neuropathy may also occur in diabetes mellitus, connective tissue diseases including Jorgen’s syndrome, and amyloidosis.
The rare Melkersson-Rosenthal syndrome
- consists of recurrent facial paralysis; recurrent—and eventually permanent—facial (particularly labial) edema; and, less constantly, plication of the tongue. Its cause is unknown.
Acoustic neuromas
frequently involve the facial nerve by local compression.
Infarcts, demyelinating lesions of MS, and tumors are the common pontine lesions that interrupt the facial nerve fibers; other signs of brainstem involvement are usually present. Tumors that invade the temporal bone (carotid body, cholesteatoma, dermoid) may produce a facial palsy, but the onset is insidious and the course progressive
All these forms of nuclear or peripheral facial palsy must distinguish from the supranuclear type. In the latter, the frontalis and orbicularis oculi muscles of the forehead involve less than those of the lower part of the face, since the upper facial muscles innervate by corticobulbar pathways from both motor cortices, whereas the lower facial muscles innervate only by the opposite hemisphere. In supranuclear lesions, there may a dissociation of emotional and voluntary facial movements, and often some degree of paralysis of the arm and leg or an aphasia (in dominant hemisphere lesions) is present.
Otitis media
- Ramsay Hunt syndrome
- Sarcoidosis or Guillain-Barre syndrome
- Tumor
- Lyme disease
- Multiple sclerosis
- Stroke
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Homeopathic Medicines for:Bell’s Palsy
Causticum: This remedy may be beneficial for Bell’s Palsy with symptoms such as weakness or paralysis of facial muscles, especially on the left side. It may also help with difficulty closing the eye on the affected side.
Hypericum: Hypericum is often recommended for nerve-related conditions, including facial paralysis. It may help reduce pain and discomfort associated with Bell’s Palsy.
Aconite: If Bell’s Palsy occurs suddenly after exposure to cold or wind, Aconite may be indicated. It can help address symptoms such as facial pain and twitching.
Gelsemium: This remedy may be suitable for Bell’s Palsy with symptoms of weakness and heaviness in facial muscles, accompanied by a feeling of lethargy or fatigue.
Silicea: Silicea is indicated when Bell’s Palsy is accompanied by pus formation or a history of suppuration.
It’s important to consult with a qualified homeopath for personalized treatment recommendations. Homeopathic remedies are chosen based on individual symptoms and constitution, so what works for one person may not be suitable for another.
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Conclusion Bell’s Palsy can be a challenging condition to navigate, but with the right support and treatment approach, relief is possible. By incorporating homeopathic remedies into your treatment plan and accessing online consultations, you can take proactive steps towards managing symptoms and promoting recovery. Don’t let Bell’s Palsy hold you back – reach out to us today and unlock the support you need to thrive.
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- Avoid hard, chewy foods as these can be difficult to prepare and choose a soft easy chew diet such as pasta dishes, fish, well cooked meats and vegetables.
- Try smaller mouthfuls as these are easier to control and less likely to spill from your mouth.
- If your mouth is dry then make sure your food is moist by adding extra butter, gravy or sauces.
- Brush your teeth after meals to ensure no food debris is left behind or trapped inside your cheek. You may need to use your finger to clear any food debris from your cheek. It is important to do this in order to avoid tooth decay.
[1]Harrison-s_Principles_of_Internal_Medicine-_19th_Edition-_2_Volume_Set
[2] Medicine Golwala
[3] Davidsons Principles and Practice of Medicine (PDFDrive.com)
[4] Medical Nutrition Therapy_ A Case Study Approach (PDFDrive)
[5] The Homoeopathic Prescriber by K. C. Bhanja
[6] https://www.asterhospitals.in/blogs-events-news/aster-medcity-kochi/bells-palsy-symptoms-causes-and-risk-factors
[7] Bell’s palsy physical examination – wikidoc
[8] afp.org/pubs/afp/issues/2007/1001/p997.html
What is Bell’s Palsy
Bell’s palsy is an acute, apparently isolated, lower motor neuron facial palsy for which no cause can be found.
Homeopathic Medicines used by Homeopathic Doctors in treatment of Bell’s Palsy
- Causticum
- Gelsemium
- Aconite
- Conium
- Bryonia
- Pulsatilla
What are the symptoms of Bell’s Palsy
- Postauricular pain
- Loss of sense of taste
- Hyperacusis and
- Watering of the eye
- Sweating less on affected side
What are the causes of Bell’s Palsy
- Diabetes, Severe hypertension
- Last trimester of pregnancy
- Dental anesthesia
- Exposure to cold
- Oedema
- Subsequent compression of nerve trunk
- Suppurativa otitis media
- Herpes zoster
- Head injury