BELL’S PALSY
DEFINITION:-
Bell’s palsy or facial paralysis (named after Sir Charles bell who first described it) is a condition characterized by isolated lower motor neuron paralysis of the facial nerve affecting one complete half of the face. Bell’s palsy is perhaps the commonest neurological condition in this country.
AETIOLOGY:-
- The cause is remain unknown, but some of predisposing factors can cause.
- Due to a viral infection resulting in swelling and compression of the inside the facial canal with consequent loss of function.
- Axonal degeneration may occur later.
- Due to stress and tension.
- Infraction in facial nerve or any blocks in facial nerves.
- Sometimes due to over usage of alcohol and drugs can leads facial palsy.
SYMPTOMS:-
- The onset is sudden. Dull aching pain may be felt in the mastoid region.
- Paralyses of one complete half of the face resulting in facial asymmetry.
- Affected side of the face looks flat with absence of the nasolabial fold and wrinkles over the forehead.
- The eye on the affected side cannot be closed and on attempting to close the eye, the eyeball rolls upwards and outwards (bell’s phenomenon).
- The cheek on the affected side cannot be blown and the patient is unable to whistle. On attempting to show the teeth, the mouth is drawn towards the healthy side.
- The ocular fissure is wider on the affected side due to weakness of the orbicularis oculi. On the attempting to raise the eye brows, the affected side of the forehead remains smooth and flat while wrinkles are present on the healthy side.
- Tears roll down the eye and saliva trickles down the angle of mouth of the affected side. Food may collect inside the cheek while eating.
- Although the affected side of the face may feel numbness, there is no objective sensory loss. Loss of sense of the taste over the anterior two-thirds of the tongue on the affected side and excessive response to sound on the affected side.
TREATMENT:-
- The drug choice is prednisolone (20 mg daily) for about the week and then tapered off gradually.
- Ibuprofen (400mg twice in day) is also useful.
- Physiotherapy should be started early but fatigue of muscles should be avoided.
- The patient should attempt to blow the cheek, close the eye and corrugate the forehead on the affected side.
- Surgical decompression of the facial nerve may be tried if the affected muscles fail to recover by the end of the 3rd week.
- Dark sunglasses should be used in order to protect the affected eye from light and dirt.
HOMEOPATHIC TREATMENT:-
1. BELLADONNA:-
Facial neuralgia with twitching muscles and flushed face. Red, bluish-red, hot, swollen, shining; convulsive motion of muscles of face. Swelling of upper lip. Eyes feel swollen and protruding, staring, brilliant; conjunctiva red; dry, burn; photophobia; shooting in eyes. Sensation as if eyes were half closed. Ocular illusions; fiery appearance.
2. CAUSTICUM:-
Paralysis of right side of the face. Pain in facial bones. Pain in jaws, with difficulty in opening mouth. Cataract with motor disturbances.Paralysis of ocular muscles after exposure to cold. Ringing, roaring, pulsating, with deafness; words and steps re-echo;Chronic middle-ear catarrh; accumulation of ear-wax. Paralysis of tongue, with indistinct speech.
3. ACONITE:-
Neuralgia, especially of left side, with restlessness, tingling, and numbness. Tingling in cheeks and numbness. On rising the red face becomes deathly pale, or he becomes dizzy. Constantly moves lower jaw as if chewing.
4. COCCULUS:-
Paralysis of facial nerve. Cramp-like pain in masseter muscle; worse, opening mouth.Prosopalgia in afternoon, with wide radiations of pain. Sick headache from carriage riding cannot lie on back part of head.
Some of other drugs are agaricus, ammonium phos, baryta carb, cuprum met, dul camara. Gelsemium, graphitis, ignitia. Kali iod, nux vomica, rhustoxi.
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