DEAR DR. GOTT:
I would like to tell you about my experience with an annoying condition, called Bell’s palsy, while on a tour in Italy.
I had been riding near an open window on our bus and woke up the next morning with partial facial paralysis (drooping cheek, mouth and more). My father had died of a stroke a few years before and some of his symptoms were similar so I became worried. Our tour director immediately took me to a doctor in the town we had spent the night in where I was diagnosed with Bell’s palsy.
It was explained to me that if I left it untreated, the affected nerve might die and cause a permanent drooping and weakness. I was then given a massive dose of vitamin B12 by injection. The doctor suggested to me that I have two more shots at six day intervals which I did. Within six weeks, the symptoms were completely gone.
The following year, almost to the day, the same thing happened. This time, however, I had been sitting near a window air conditioning unit at work. Upon waking the next morning, I found that my face had the same partial drooping and weakness.
I went to my primary care physician who wasn’t very concerned. He suggested it was a temporary thing and would probably go away in time which was quite the contrary of what the Italian doctor had told me. When I related my previous experience, my doctor indicated that he had never heard of such a thing but agreed to give it a try. So, on my instruction, he gave me the three shots, each six days apart and was somewhat amazed when the symptoms disappeared in about six weeks.
In reviewing this with some doctor friends and other medical personnel, none seemed to have heard of this treatment, yet the Italian physician made a very quick diagnosis and treatment of the Bell’s palsy as if it were common knowledge in his area.
Do Italian doctors know something that American physicians do not in regard to treating this condition?
Bell’s palsy is a condition that causes partial facial paralysis and weakness. It can occur at any age but rarely affects those over 60 or under 15. It is important, once the facial paralysis or weakness has been discovered, to be seen immediately by a physician or hospital emergency room to ensure the symptoms are not due to a stroke.
Symptoms include the sudden onset or paralysis or weakness on one side of the face, loss of taste, headache, pain in, in front of, or behind the ear on the affected side, changes in the amount of tears and saliva produced, facial drooping and difficulty making facial expressions, and more.
The cause of Bell’s palsy is nerve damage. On each side of the face, there is a narrow tunnel of bone through which a nerve passes. These nerves control the facial muscles on each side of the face. When either of the nerves become inflamed or swollen, it can be pinched by the bone. The pressure can then damage the protective covering over the nerve leading to poor or absent communication between it and the facial muscles.
There are several reasons why this facial nerve can become pinched. The most common cause is the herpes simplex virus (colds sores or genital herpes). Other known viruses include herpes zoster (chicken pox and shingles), Epstein-Barr (mononucleosis), and cytomegalovirus (mono-like syndrome). It has also been linked to Lyme disease, pregnancy, diabetes and upper respiratory infections.
Most individuals will recover from Bell’s palsy within one to six months without treatment, depending on the severity of symptoms. For more severe or prolonged symptoms, your physician may recommend physical therapy, prescription medications or even alternative therapies.
Currently there are two types of prescription medications used to treat Bell’s palsy, but study results have been mixed. Corticosteriods, such as prednisone, can reduce swelling and inflammation which, for some, can lead to improvement. Antiviral drugs, such as Famvir, may be given to those with known viral infections. Physical therapy to massage and exercise the facial muscles can reduce the extent of weakness and paralysis which can reduce the risk of developing permanent damage to the muscles.
Alternative therapies such as biofeedback, acupuncture, relaxation techniques and vitamin therapy (B12, B6 and zinc) have proven successful in reducing symptoms and duration of Bell’s palsy for some individuals.
I am not sure that Italian doctors know something about the condition we do not know, however, I believe they may simply be more accepting of alternative therapies. American doctors are a bit more skeptical, which can be both a blessing and hindrance, depending on the situation. In terms of Bell’s palsy, I don’t see anything wrong with vitamin therapy. Even if it does not work, it is safe and chances are, recovery will take place on its own anyway.