Bell’s Palsy
Also indexed as: Facial Nerve Palsy, Facial Paralysis
When one side of the face suddenly feels weak and numb, a nerve
disorder may be the underlying reason. According to research or other evidence, the following
self-care steps may help people with Bell’s palsy:
- Try an OTC eye treatment
- Help control eye symptoms with over-the-counter artificial tear
solutions, such as polyvinyl alcohol (HypoTears, Murine, Liquifilm Tears), hydroxypropyl
methylcellulose (Tears Naturale Free, Ultra Tears), and carboxymethylcellulose (Refresh Plus,
Celluvisc)
- Talk to your doctor
- Ask about prescription-strength corticosteroid drugs, such as
prednisone (Deltasone, Orasone), methylprednisolone (Medrol), and prednisolone (Prelone,
Pediapred, Orapred), to help reduce paralysis and speed recovery
- Get a checkup
- Visit your healthcare professional to find out if you have a
disease, such as diabetes or hypertension, that is associated with Bell’s palsy
- Consider vitamin B12 injections
- Consult a healthcare practitioner knowledgeable in the use of
vitamin B12 injections to find out if this treatment will speed your recovery
- Discover HBT
- Consult a healthcare practitioner knowledgeable in the use of
hyperbaric oxygen therapy to find out if this procedure may quicken your recovery
These recommendations are not comprehensive and are not intended to replace
the advice of your doctor or pharmacist. Continue reading the full Bell’s palsy article
for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and
lifestyle changes that may be helpful.
About Bell’s palsy
Bell’s palsy is a disorder of the nerve that controls certain muscles of the
face.
People with Bell’s palsy lose control of some or all of the muscles on one half of
the face; consequently, the face looks asymmetrical. Rarely are both sides of the face
affected. The cause is unknown, and the disorder usually resolves without treatment within six
to twelve months.
People with diabetes or hypertension have greater-than-average risk for
Bell’s palsy.1 2 3 While no research has investigated
whether better control of these conditions may help prevent Bell’s palsy, people with
Bell’s palsy should be checked for diabetes and hypertension, especially if the palsy
occurs repeatedly or affects both sides of the face.
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| See also: Homeopathic Remedies for Bell’s palsy |
What are the symptoms?
Some common symptoms of Bell’s palsy include a rapid onset of weakness, numbness,
heaviness, or paralysis of one side of the face. People with Bell’s palsy may also have
symptoms of pain behind the ear, inability to completely close one eye, drooling, and speech
difficulties.
Other therapies
Skin tape or an eye patch may be used to help the eye stay closed and lubricated. Difficult
cases may require a surgical procedure in which the eyelids are stitched together.
Vitamins that may be helpful
Vitamin B12 deficiency can cause nerve
degeneration,4 and both oral5 and injected6 7
vitamin B12 have been used to treat many types of nerve disorders.8 One older case
report described successful treatment of chronic Bell’s palsy with vitamin B12
injections of 500 to 1,000 mcg given every one to two days.9 A more recent trial
compared the effect of 500 mcg of injected vitamin B12 (in the form of methylcobalamin) given
three times weekly for at least eight weeks—steroid medication, or both. Researchers
found significantly faster recovery in the groups given B12 injections with or without
steroids, compared to those given steroids alone.10 These findings agree with
earlier reports on the effectiveness of methylcobalamin injections for Bell’s
palsy.11 12 It is unlikely that oral vitamin B12 would be similarly
effective. People seeking B12 injections should consult a physician.
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.
Holistic approaches that may be helpful
Many reports claim that acupuncture speeds
recovery from Bell’s palsy,13 14 15 16 but
no controlled trials have been done to confirm this is neither a placebo effect nor the
natural course of healing.
Hyperbaric oxygen therapy (HBT) is a
procedure in which the patient breaths 100% oxygen at pressures up to three times greater than
normal atmospheric pressure. A well controlled study of Bell’s palsy patients compared
HBT plus a placebo tablet with fake oxygen therapy plus steroid medication.17 HBT
produced significantly faster recovery (22 vs. 34 days) compared to the use of steroids.
Biofeedback techniques (using simple
electronic devices to measure and report information about a person’s biological system)
have been reported to help limit the deterioration of muscle function and speed recovery in
Bell’s palsy.18 19 However, a controlled trial of patients with
chronic facial paralysis (including some with Bell’s palsy) found that using a mirror as
feedback was as effective as a mirror plus electrical biofeedback for improving facial
symmetry and muscle function.20
References
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1. Adour K, Wingerd J, Doty HE. Prevalence of concurrent diabetes
mellitus and idiopathic facial paralysis (Bell’s palsy). Diabetes
1975;24:449–51.
2. Yanagihara N, Hyodo M. Association of diabetes mellitus and
hypertension with Bell’s palsy and Ramsay Hunt syndrome. Ann Otol Rhinol Laryngol
Suppl 1988;137:5–7.
3. Brandenburg NA, Annegers JF. Incidence and risk factors for
Bell’s palsy in Laredo, Texas: 1974–1982. Neuroepidemiology
1993;12:313–25.
4. Savage DG, Lindenbaum J. Neurological complications of acquired
cobalamin deficiency: clinical aspects. Baillieres Clin Haematol 1995;8:657–78
[review].
5. Yaqub BA, Siddique A, Sulimani R. Effects of methylcobalamin on
diabetic neuropathy. Clin Neurol Neurosurg 1992;94:105–11.
6. Ide H, Fujiya S, Asanuma Y, et al. Clinical usefulness of intrathecal
injection of methylcobalamin in patients with diabetic neuropathy. Clin Ther
1987;9:183–92.
7. Kuwabara S, Nakazawa R, Azuma N, et al. Intravenous methylcobalamin
treatment for uremic and diabetic neuropathy in chronic hemodialysis patients. Intern
Med 1999;38:472–5.
8. Yamane K, Usui T, Yamamoto T, et al. Clinical efficacy of intravenous
plus oral mecobalamin in patients with peripheral neuropathy using vibration perception
thresholds as an indicator of improvement. Curr Ther Res 1995;56:656–70
[review].
9. Mitra M, Nandi AK. Cyanocobalamin in chronic Bell’s palsy. J
Indian Med Assoc 1959;33:129–31.
10. Jalaludin MA. Methylcobalamin treatment of Bell’s palsy.
Methods Find Exp Clin Pharmacol 1995;17:539–44.
11. Kobayashi H, Aoyagi M, Suzuki H, et al. The clinical effects of
mecobalamin on peripheral facial palsy. Otolaryngology 1980;26:968–72.
12. Yagi N, Ishikawa Y, Fukazawa T. The effect of steroid and CH3 vitamin
B12 on peripheral facial paralysis. Otologia Fukuoaka 1981;74:1613.
13. Zhang Y. Clinical experience in acupuncture treatment of facial
paralysis. J Tradit Chin Med 1997;17:217–9.
14. He S, Zhang H, Liu R. Review on acupuncture treatment of peripheral
facial paralysis during the past decade. J Tradit Chin Med 1995;15(1):63–7
[review].
15. Yuan H, Zhang J, Feng X, Lian Y. Observation on electromyogram
changes in 93 cases of peripheral facial paralysis treated by point-through-point acupuncture.
J Tradit Chin Med 1997;17:275–7.
16. Zang J. 80 cases of peripheral facial paralysis treated by
acupuncture with vibrating shallow insertion. J Tradit Chin Med
1999;19:44–7.
17. Racic G, Denoble PJ, Sprem N, et al. Hyperbaric oxygen as a therapy
of Bell’s palsy. Undersea Hyperb Med 1997;24:35–8.
18. Biedermann HJ, Inglis J. The restoration of control in facial muscles
affected by Bell’s palsy. Int J Psychosom 1990;37:73–7.
19. Lobzin VS, Tsatskina ND. The adaptive biological control system with
electromyographic feedback in the treatment of Bell’s palsy. Zh Nevropatol Psikhiatr
Im S S Korsakova 1989;89(5):54–7 [in Russian].
20. Ross B, Nedzelski JM, McLean JA. Efficacy of feedback training in
long-standing facial nerve paresis. Laryngoscope 1991;101:744–50.
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