Bells-Palsy Pain Management

What is Bells Palsy?

Bells-Palsy is a temporary facial paralysis resulting from damage or trauma to one of the two facial nerves. The facial nerve is named the 7th cranial nerve. It travels through a narrow bony canal (named the Fallopian canal) in the skull, beneath the ear, to the muscles on each side of the face (right underneath the ridge of your cheekbone). For most of its journey, the nerve is encased in this bony shell.

With Bells-Palsy, each facial nerve controls the muscles on each side of the face, including those that control eye blinking and closing, and facial expressions such as smiling and frowning.. Additionally, the facial nerve carries impulses to the tear glands, the saliva glands, and the muscles of the small bone in the middle of the ear, named the stapes. The facial nerve also transmits taste sensations from the tongue.

When Bells-Palsy occurs, the function of the facial nerve is disrupted, causing an interruption in the messages that the brain sends to the facial muscles. This interruption results in the facial weakness and/or paralysis.

Bells-Palsy is named for Sir Charles Bell, a 19th century Scottish surgeon who was the first to describe the condition. The disorder, which is not related to a stroke, is the most common cause of facial paralysis. Generally, it affects only one side of the face, however in rare cases, it can affect both sides.

What are the Symptoms of Bells Palsy?

In Bells-Palsy, the facial nerve has so many functions and is so complex, damage to the nerve or a disruption can lead to many problems. Symptoms can vary from person to person and range in severity from mild weakness to total paralysis, may include twitching, weakness or paralysis on one or both sides of the face, drooping of the eyelid and corner of the mouth, drooling, dryness of the eye and/or mouth, impairment of taste, and excessive tearing of one eye. Most of these symptoms, which usually begin suddenly and reach their peak within 48 hours, lead to severe facial distortion.

Other symptoms may include pain or discomfort around the jaw and behind the ear, ringing in one or both ears, headache, loss of taste, hypersensitivity to sound on the affected side, impaired speech, dizziness, and difficulty eating or drinking.

What Causes Bells Palsy?

Bells-Palsy occurs when the nerve that controls the facial muscles is swollen, inflamed or compressed, resulting in facial weakness or paralysis. Exactly what causes the damage is unknown.

With Bells Palsy, most scientists believe that a viral infection such as viral meningitis or the common cold-sore virus, herpes simplex, causes the disorder. They believe that the facial nerve swells and becomes inflamed in reaction to the infection, causing pressure within the Fallopian canal and leading to an infarction (the death of nerve cells due to insufficient blood and oxygen supply). In some mild cases where the recovery is rapid, there is damage only to the myelin sheath of the nerve. The myelin sheath is the fatty covering which acts as an insulator-on nerve fibers in the brain.

The disorder has also been associated with influenza or a flu-like illness, headaches, chronic middle ear infection, high blood pressure, diabetes, sarcoidosis, tumors, Lyme disease and trauma, such as skull fracture or facial injury.

Who Gets It?

Bells-Palsy afflicts approximately 60.000 North Americans each year. It affects men and women equally and can occur at any age. It is less common before age 15 or after age 60. It disproportionately attacks pregnant women and people who have diabetes or upper respiratory ailments such as the flu and a cold.

How is it Diagnosed?

A diagnosis of Bells-Palsy is made based on clinical presentation....including a distorted facial appearance and the inability to move muscles on the affected side of the face….and by ruling out other possible causes of facial paralysis. There isn’t any specific laboratory test’s to confirm diagnosis of the disorder.

Normally, a doctor will examine the individual for upper and lower facial weakness. In most cases the weakness is limited to one side of the face and occasionally to the forehead, eyelid or mouth. An EMG test can confirm the presence of nerve damage and determine the severity and the extent of nerve involvement. An X-ray of the skull can help rule out an infection or a tumor. An MRI or CT scan can eliminate other causes of pressure on the facial nerve.

How is it Treated?

There is no cure or standard course of treatment for Bells Palsy with the exception of Massage and Reiki manipulations to the affected area. Primarily the 7th cranial nerve needs to be lightly massaged along its length. It is located right underneath the cheekbone. Therefore, a pinky finger is to be inserted in the mouth and gently stroked along its length. This should be performed, along with gentle rotating massage on the side of the face, the ear and behind the ear, for 15 to 25 minutes 2 to 3 times a day. Reiki and a warm compress will help heal the disfigured area and hence will provide you pain management. As each day passes, the pain will decrease and the paralysis will subside. This method has produced results of non-paralysis in 1 to 4 months, and in most cases, the part of the face will return to normal function.

Bells Palsy affects each individual differently. Some cases are mild and do not require treatment as the symptoms usually subside on their own within 2 weeks. For others, treatment may include medications and Massage and Reiki process.

Recent studies have shown that steroids are an effective treatment and that an anti-viral drug such as acyclovir, is used to fight viral infections. It is often combined with an anti-inflammatory drug such as the steroid prednisone, which is used to reduce inflammation and swelling. Analgesics such as aspirin, acetaminophen or ibuprofen may relieve pain. Because of possible drug interactions, patients taking prescription medications should always talk to their doctors, before taking any over-the-counter drugs.

Another important factor in the treatment process is eye protection. Bells Palsy can interrupt the eyelid’s natural blinking ability, leaving the eye exposed to irritation and drying. Therefore keeping the eye moist and protecting the eye from outside irritants is important. Especially at night, it is important to use lubricating eye drops, such as artificial tears or eye ointments and eye patches.

In general, decompression surgery to relieve pressure on the nerve is controversial and is seldom recommended. On rare occasions, cosmetic or reconstructive surgery made be needed to reduce deformities and correct some damage such as an eyelid that will not fully close or a crooked smile.

Summary

The prognosis for individuals with Bells-Palsy is generally good. The extent of nerve damage will determine the extent of recovery. Improvement is gradual and recovery times vary. However, with the help of your doctor’s drug recommendations and the use of Massage and Reiki will heal the affected area much sooner.



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