DEAR READER:
Done.

In all honesty, I hadn’t thought of speech therapy as a treatment for Bell’s palsy. When most people think of speech therapy, they think it is used for children who have difficulty enunciating properly or have facial deformities (such as a cleft palate) that make speaking difficult.

So readers, if you are suffering from Bell’s palsy, consider a referral to a speech therapist familiar with treating the condition. Similarly, if any readers have had positive (or negative) results from speech therapy for Bell’s palsy, please let me know. I will print a follow-up.

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?

DEAR READER:
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.

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.