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. [1]
(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 [2]
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.
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 [3]
Vesicles within the external auditory meatus and ear drum in Ramsay Hunt syndrome. Pain may precede facial weakness. Deafness may result .[2]
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.
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. [1]
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. [1]
Symptomatic measures include
(1) The use of paper tape to depress the upper eyelid during sleep and prevent corneal drying.
(2) Massage of the weakened muscles.
A course of glucocorticoids, given as prednisone 60–80 mg daily during the first 5 days and then tapered over the next 5 days, modestly shortens the recovery period and improves the functional outcome. Although large and well controlled randomized trials found no added benefit of the antiviral agents valacyclovir (1000 mg daily for 5–7 days) or acyclovir (400 mg five times daily for 10 days) compared to glucocorticoids alone,
some earlier data suggested that combination therapy with prednisone plus valacyclovir might be marginally better than prednisolone alone, especially in patients with severe clinical presentations. For patients with permanent paralysis from Bell’s palsy, a number of cosmetic surgical procedures have been used to restore a relatively symmetric appearance to the face. [1]
Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines are selected after a full individualizing examination and case-analysis,
The disease diagnosis is important but in homeopathy, the cause of disease is not just probed to the level of bacteria and viruses. Other factors like mental, emotional and physical stress that could predispose a person to illness are also looked for. No a days, even modern medicine also considers a large number of diseases as psychosomatic. The correct homeopathy remedy tries to correct this disease predisposition.
The focus is not on curing the disease but to cure the person who is sick, to restore the health. If disease pathology is not very advanced, homeopathy remedies do give a hope for cure but even in incurable cases, the quality of life can be greatly improved with homeopathic medicines.
The homeopathic remedies (medicines) given below indicate the therapeutic affinity but this is not a complete and definite guide to the homeopathy treatment of this condition. The symptoms listed against each homeopathic remedy may not be directly related to this disease because in homeopathy general symptoms and constitutional indications are also taken into account for selecting a remedy.
This remedy also has paralysis from exposure to the cold of winter. Facial paralysis from exposure to dry cold weather. Cowperthwaite published a large number of cases of facial paralysis cured with Causticum 30, and its value in this affection seems established. It has also paralysis of single parts, face, tongue, pharynx, etc.
Complete motor paralysis, rather functional than organic in origin. It is one of our best remedies in post-diphtheritic and in infantile paralysis. Paralysis of the ocular muscles, ptosis; the speech is thick from paretic conditions of the tongue. Paralysis from emotions. Aphonia, paralysis of the larynx.
Complete motor paralysis, rather functional than organic in origin. It is one of our best remedies in post-diphtheritic and in infantile paralysis. Paralysis of the ocular muscles, ptosis; the speech is thick from paretic conditions of the tongue. Paralysis from emotions. Aphonia, paralysis of the larynx.
Palsy of old people esp. old women. “Conium may be useful in paralysis, especially partial, the patient being weak and continuously trembling; the limb continually trembling; the limbs give out when walking and he falls forward; sudden attacks of giddiness and faintness. “Palsy after concussion of spine.
Abnormal hunger, loss of taste. Dryness of mouth, tongue also throat with excessive thirst. Especially, Tongue coated yellowish, dark brown; heavily white in gastric derangement. At last, Lips swollen, dry cracked.
Dry mouth without thirst. Crack in middle of lower lip. Offensive odour from mouth. Frequently licks dry lips. Loss of taste. Besides this, Alteration of taste, bitter, bilious, greasy, salty, foul. [5]
Bell’s palsy is an acute, apparently isolated, lower motor neuron facial palsy for which no cause can be found.
References:
"*" indicates required fields
We are a multi-specialty healthcare facility, delivering world-class healthcare, at an optimum cost. Our aim is to deliver Affordable, Accessible, and Accurate healthcare to all sections of society.
