Monday, July 10, 2017

Natural Treatments for Bell's Palsy: Acupuncture, Exercise, and More

About 20 years ago I wrote an article on natural treatments for Bell's palsy, acupuncture, exercise, massage, vitamins, and the like. I'll start with what people who have Bell's palsy really want to know, which is what they can do about it right now without buying anything or seeing a doctor.

Try massage and then exercise:

Facial massage followed by moist, warm compresses with just a moistened towel is helpful during the early weeks of Bell’s palsy, when muscles are flaccid. Facial exercises should not be tried until after the nerve begins to heal, usually at least a month after the onset of symptoms. The muscles themselves will not atrophy even if they are not exercised, but you can accelerate healing by visualizing normal facial movements even if you cannot make facial muscles move. This keeps the brain-muscle connections active and helps you recover faster. After 2-3 months try visualizing and then moving muscles as follows:

Flare your nostrils.
Sniffle, then wrinkle your nose.
Smile without showing your teeth, then with showing your teeth.
Try moving your lips into a small smile gently, then try puckering both sides of your mouth equally.
Stick your chin out like a boxer.
Using your thumb and index finger, move your lips inward from the sides and then outward, gently. Then continue the motion, gently pulling your lips up and down with your mouth closed.
Frown and draw eyebrows downward.
Do not chew gum; this exercises the wrong muscles.
When you are alone, try using both sides of your mouth equally as you chew food.

If you are having trouble separating mouth and eye movements, practice smiling. Start small, smiling only as widely as you can without exaggerated eye movement. You can also practice saying words beginning with B, F, M, or P while keeping your eyes open.

If you are beginning facial exercises six or more months after onset of symptoms, your muscles may have learned inappropriate motions. Doing these exercises will help muscles unlearn inappropriate motions and relearn natural motions. It is never a good idea to force muscle motion. If muscles won’t move, visualizing movement keeps the brain-muscle connection active while the nerve regenerates.

Now I'll back up a bit. Maybe you're not totally sure what you're exercising for. What's Bell's palsy?

Bell’s palsy beging with intense facial pain and progresses to varying degrees of facial paralysis usually in less than a week. Bell’s palsy symptoms may include most or all of the following:

Pain behind or in front of one ear, followed 1–2 days later by face feeling stiff or pulled to one side
Synkinesis, an abnormal contraction of the facial muscles when closing the eyes Easy to frown, hard to smile
Drooping face
Difficulty closing one eye
Reduced taste sensitivity
Hypersensitivity to sound, but only in the affected ear
Difficulty eating and drinking
Inappropriate secretion of tears (“crocodile tears”) when laughing or talking

Bell’s palsy more commonly strikes the right side of the face. In about 1 per cent of cases, Bell’s palsy affects both sides of the face. Other neurological conditions must be ruled out when symptoms affect the face bilaterally. The presence of these symptoms with blisters in the ear suggests Ramsey-Hunt Syndrome. (See also Ramsey-Hunt Syndrome.)

 Named in 1828 by the Scottish neurologist Charles Bell, Bell’s palsy triggers intense pain and then paralysis of one side of the face. This frequently misdiagnosed condition results from inflammation or damage to the nerve controlling facial expression, cranial nerve VII. This nerve enables eyelids to close and the corners of the mouth to go up in a smile on the side of the face it controls. Cranial nerve VII similarly controls the production of tears and saliva and the senses of taste and smell. The unaffected side of the forehead may wrinkle but the affected side of the forehead will not.
People often remember exposure to a cold draft just before developing Bell’s palsy. A stormy day after a clear day also often initiates the disease.2 Environmental stress may be the only common denominator for the disease, because there are many other risk factors.

Anywhere from 1 in 5,000 to 1 in 250 people develops Bell’s palsy in any given year. The disease most commonly strikes people over 60 years old and pregnant women in their third trimester, but it can occur at any stage of life. Fortunately, Bell’s palsy usually goes away on its own in 6–12 months, recurring in only 4 to 14 per cent of cases. The changes in appearance induced by this disease are often distressing, but they are never permanent.

What are the nutritional supplements that help in Bell’s palsy?

Vitamin B12: Given by injection by a nutritionally oriented health practitioner

 If you have had shingles, also take:

 ∆ Essential fatty acids (fish oil or DHA from marine algae, etc.): 5,000 mg daily
Pyruvate: 3,000 mg daily
Vitamin E: 400 IU daily

What will your doctor do if you are diagnosed with Bell’s palsy?

Doctors typically prescribe a 10-day course of treatment for Bell’s palsy with either steroids, such as Prednisone, or antivirals, usually aciclovir, even though neither drug has been confirmed by reliable clinical studies to yield any benefit beyond the first few days of treatment.

An intervention that works for Bell’s palsy, however, can be found in vitamin B12. A clinical trial in Malaysia found that standard medical treatment with steroids brought about complete recovery in average of 10 weeks, although recovery times ranged from a few days to nearly half a year. Adding vitamin B12 to steroid treatments accelerated the healing process to 1 to 3 weeks, while using vitamin B12 by itself also brought about complete healing in an average of 2 weeks. The vitamin-only treatment group had the smallest number of patients requiring more than 3 weeks for recovery.
The only drawback to using vitamin B12 to treat Bell’s palsy is that it must be given by injection. Vitamin B12 is nontoxic even when it is taken in a dosage 1,000 times greater than the RDA.

Medical scientists learned that the virus that causes shingles can also cause Bell’s palsy back in the 1970’s. If you have had shingles, three other supplements may also help accelerate your recovery. Laboratory experiments have shown that vitamin E, sodium pyruvate (a sports supplement), and membrane-stabilizing free fatty acids work together to stop lesions in herpes simplex, the herpesvirus responsible for genital herpes.It is likely, although not scientifically proven, that will act the same way in treating complications of other forms of herpesvirus, such as the shingles virus, most commonly associated with Bell’s palsy.  

Taking more than 2,000 IU of vitamin E and blood thinning agents such as aspirin, warfarin (Coumadin), or clopidogrel (Plavix) on the same day can make you especially susceptible to bleeding. Overdosing pyruvate can cause abdominal bloating, gas, and diarrhea. Any essential fatty acid can cause burping, flatulence, and runny stools if taken in overdose, although these symptoms are uncommon at a dosage of 5,000 mg per day.

Developing Bell’s palsy may be a warning sign of other serious conditions. Diabetes is a risk factor for Bell’s palsy, as is a family history of the disease. (Steroid drugs, however, can raise blood sugars causing a false positive test for diabetes.) Bell’s palsy may follow infection with the virus that causes shingles or infection with syphilis, tuberculosis, or HIV. Bell’s palsy can occur with autoimmune diseases such as rheumatoid arthritis, sarcoidosis, and Sj√∂gren’s syndrome, or result from poor circulation. Chronic ear infections contribute to Bell’s palsy, since cranial nerve VII leaves the skull near the middle ear.

In the Maritime provinces of Canada, in New England, and in the Middle Atlantic states of the US, about 1 in 3 cases of Bell’s palsy can be attributed to infection with Borrelia burgdorferi, the bacterium that causes Lyme disease. The most common medical designation for Bell’s palsy, however, is “idiopathic,” that is, the doctor can find no underlying condition responsible for symptoms.

Concepts for Coping with Bell’s Palsy

If you have had Bell’s palsy in the past, consider taking the supplements listed above whenever you know are going to experience emotional or environmental stress. It is possible that supplementation may reduce the risk of recurrence, especially if you have had shingle.
Chronic, slow worsening of symptoms may be due to a tumor affecting the cranial nerve and calls for medical examination. Bell’s palsy does not affect other areas of the body.
Symptoms on both sides of the face are most often triggered by flu, Guillan-Barre syndrome, Lyme disease, or mononucleosis. They may also be a complication of sarcoidosis.
In Bell’s palsy, the lacrimal glands at the corners of the eye continue to produce tears, but the affected eye does not blink often enough to spread them. A simple remedy is to simulate a blink by rubbing your eyelid with the back of your finger. Alternatively, you can use artificial tears in your affected eye several times a day to prevent drying and infection. Problems focusing the eye indicate severe dryness requiring immediate relief. A stinging or burning sensation also indicates dry eye, even if there are tears in the corner of the eye.

GenTeal and Tears Naturale eye drops use a natural preservative that is less irritating to the eye. Celluvisc provides excellent lubrication, but is so viscous that it may interfere with vision.
Eagle Vision’s Rectangular Moist Eye Moisture Chamber and Franel Optical’s Moisture Chamber also help maintain moisture in the eye. They are available with a doctor’s prescription. Wraparound sunglasses and even swimming goggles offer some relief.

If you have trouble closing your eye, consider a pirate’s patch for nighttime protection. Franel Optical makes a “Peel and Press Occluder” that keeps the patch from shifting during sleep. HypoTears, Lacrilube, and ViscoTears offer long-lasting nighttime lubrication in gel form.
If you cannot keep the eye moist, you must not wear a contact lens. Corneal damage may result.
Head injury can cause recurrences of Bell’s palsy. Be sure to wear a helmet when cycling or playing contact sports.

Bell’s palsy is an extremely common condition in the Chinese city of Kumming. Acupuncturists there have become adept at treating disease symptoms. In their technique, needles are inserted and withdrawn from a succession of points served by cranial nerve VII on the unaffected side of the face. Patients usually begin to improve after 2 weeks of acupuncture treatment.

Botox injections are often recommended to control inappropriate facial movements. Aside from the expense, potential drawbacks to Botox treatments include drooping eyelids, blurred vision, double vision, sagging or open mouth, excessive tearing, and delayed recovery. Many find massage and exercise far less expensive—free—and more effective.

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