DEAR DR. GOTT:
I have been suffering with Bell’s palsy for over one year. Although I have shown remarkable recovery, I have not returned to normal. I still can’t whistle, nor do I have total control of the left side of my face.
From this point, I am at my wit’s end about getting back to normal. Is there anything I can do to improve my condition? Over the course of the last four months, I have not shown any more progress.
DEAR READER:
Bell’s palsy is facial paralysis that results from damage or trauma to one of the two facial nerves. As a general rule, one side of the face is affected; however, both sides can be involved. Symptoms can come on suddenly without warning and reach their peak within 48 hours. The condition can occur at any age, but generally doesn’t affect individuals under the age of 15, or those over 60. Some cases are mild, don’t require treatment and all symptoms subside within two weeks without treatment. Other cases result in a drooping eyelid or mouth corner, excessive tearing, facial paralysis, twitching, weakness, facial distortion, and dry mouth. For severe cases, medication such as acyclovir, perhaps coupled with prednisone (a steroid), is sometimes used to reduce inflammation. Alternative therapy might include relaxation techniques, heat, biofeedback, and acupuncture and vitamin/mineral therapy of B6, B12 or zinc.
Surgery to relieve pressure on the affected nerve can be done, but the procedure is controversial and generally not recommended except in severe cases that don’t heal.
About 40,000 individuals develop Bell’s palsy each year. Scientists believe a viral infection is most often the cause of the palsy with herpes simplex (the common cold sore virus), herpes zoster (the shingles virus) and viral meningitis bringing on the condition most often.
While there is no specific testing, a primary care physician can generally make a diagnosis based on a visual examination only. If questions remain, an electromyograph (EMG) can confirm the presence of any nerve damage. X-ray, MRI or CT scan can be ordered to eliminate other possible sources of pressure on the nerve.
I don’t know if the actual cause of your palsy was ever identified and what medication you might have been on but I am concerned your palsy has lasted more than a year. It may be time for you to speak frankly with your primary care physician to get his view on the situation. Is he or she is completely satisfied with your progress or was a full recovery anticipated six months ago? If you are satisfied with the performance of your physician, stick with the program. If not, perhaps it is time for a referral to a neurologist, or for you to get a second opinion on your own from another primary care physician. I don’t doubt your diagnosis, but another physician might have other views and could suggest more aggressive therapy.
To give you related information, I am sending you a copy of my Health Report “Medical Specialists”. Other readers who would like a copy should send a self-addressed, stamped, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.
About Dr. Gott