by Fay Meling von Moltke Pao,
Hon.DHSc., B.HSc., Hon.B.A.
Fay-Meling von Moltke Pao
practices Oriental Medicine in downtown Toronto, Ontario.
She is experienced in treating patients using acupuncture,
herbal medicine, nutritional counselling, tuina, and qigong.
For more information on Bell's palsy or other health concerns,
please contact her at meling at simpatico dot ca
| Imagine that you are getting ready to go
to work and are feeling totally fine one minute, and then
suddenly realizing that half of your face feels a cold, numbing
sensation, like you've just been to the dentist and had your
mouth frozen with the anaesthesia. By the time you look in
the mirror, the affected side is totally paralyzed and your
normally smiling face now has one corner that droops down.
One of your eyes has a swollen eyelid that can no longer close
shut. When you try to eat, you keep biting your lip because you
can no longer feel it, and the numbing sensation is starting to
radiate to the other side of your face. For most people with Bell's
palsy, the effects can be severely disfiguring and can cause great
anxiety. Often the first thing that people think of is that they've
had a stroke.
This was the case for a fifty-one year old male who worked as
a medical lab technician and was experiencing soreness in his
left eye for the past two weeks prior to coming to our clinic.
The patient had been recently diagnosed with Bell's palsy by his
family physician and was prescribed Valtrex (an anti-viral) that
he took consistently (50mg, 2 tablets 3x/day for 7 days). On his
initial visit, he mentioned that he had been unable to close his
left eye for the past four days. The entire left side of his face
was frozen and numb, and the numb sensation was especially noticed
when trying to eat. The numbness had begun to radiate towards
the right lower lip and the right side of his nose. Upon general
inspection, the patient's face looked flushed and the skin on
the left side of his face looked swollen and taut, especially
above his left eyebrow and below his lower lip. The swollenness
and tautness extended towards the right side.
Bell's palsy is a peripheral (affecting the peripheral rather
than the central nervous system) facial paralysis that results
from damage to the seventh cranial nerve, or "facial nerve."
Due to paralysis of the facial nerve, symptoms can include inability
to lift or close one eye, difficulty moving facial muscles on
one side of the face, lacrimation (eye tearing) on the affected
side, distortion of taste (especially on the first 2/3 of the
tongue) and tingling around the lip area (all on the affected
side). The condition has an abrupt onset and is idiopathic in
nature (no known cause). Bell's affects approximately 40, 000
people in the United States each year. Persons who tend to be
most at risk are pregnant women, and persons afflicted with the
flu virus, cold, respiratory illness, or diabetes. Some patients
have reported having severe ear, nose, mouth or gum infections
and/ or headaches prior to developing Bell's palsy. While the
cause of Bell's palsy has not been confirmed, it is likely that
viruses such as the herpes simplex virus (that contributes to
mouth sores) as well as other herpes viruses such as herpes zoster
(which leads to shingles) are responsible for the inflammation
of the facial nerve causing facial paralysis. Common treatment
therapies involve the use of acyclovir or Valtrex (an anti-viral
drug for targeting the herpes viruses), prednisone (which blocks
immune function to prevent inflammation of the affected nerve
and surrounding tissue), and corticosteroids (for reducing inflammation
around the nerve and any pain associated with the inflammation).
The prognosis for Bell's palsy ranges from complete recovery within
a few weeks (85% of patients) to chronic symptoms of facial paralysis
(15% of patients). In addition, it is necessary to rule out other
causative factors for facial paralysis including those that affect
the central nervous system such as cerebrovascular accidents (stroke)
and intracranial tumours. This can be determined through differential
diagnoses and X-rays, ultrasound, and MRI.
In this particular patient's condition, the typical symptoms
of tingling and numbness in the affected region combined with
an inability to close the left eyelid and motor impairment of
the lips and mouth on the affected side are all indicative of
Bell's palsy. In traditional Chinese medicine, this condition
is due to pathogenic wind-cold attacking the Shaoyang (Liver,
Gall Bladder) and Yangming (Stomach, Large Intestine) channels
as well as the tendons and muscles. This can occur when a patient
is exposed to wind (e.g.sleeping near an open window, driving
with the windows down, going on a boat when the winds are strong)
and is more common in the spring and autumn months. Often people
with Bell's palsy have a deficient immune system (possibly due
to genetics, unresolved or chronic illness, improper diet, rest,
exposure to toxic chemicals or drugs, or undue physical and emotional
stress). As a result, they are more vulnerable to outside sources
such as further exposure to physical and emotional stress factors
or viral and bacterial pathogens. The exposure to the external
source causes the immune system to produce an inflammatory response
in the affected region resulting in swelling of the surrounding
tissues. This swelling can then obstruct the normal function of
the nerves and vessels (ie. the facial nerve). As a result, there
is an obstruction of qi (vital energy) and blood in these areas
that leads to malnourishment of the tendons and muscles and thus
a propensity for the facial muscles to become lax or paralyzed.
The lack of nourishment to the local area can therefore cause
symptoms of numbness and tingling, which are common signs of qi
and/or blood deficiency in TCM (Traditional Chinese Medicine).
The treatment principle used in this patient's case was to use
a few distal and several local acupuncture points to eliminate
wind, regulate qi and blood in the Shaoyang and Yangming channels
in order to remove obstruction and restore facial nerve function.
After four treatments within a one-week period, the patient's
facial muscles and facial nerve function were fully restored.
While some cases of Bell's palsy will spontaneously resolve within
a few weeks, this is likely due to the severity of the attack
(e.g., the less severe, the easier and less time it takes for
the body to fight off the disease). In most Bell's palsy cases
however, the patient has a deficient immune system that prevents
them from effectively combating the illness and subsequently,
the condition may linger or even return. Since acupuncture can
help to move the blood circulation and energy to the affected
site to help restore function, and also has immune enhancing effects,
it is a welcome addition to the treatment of peripheral facial
paralysis that can increase the potential for a faster and complete
recovery. To prevent future recurrences of the disease, it is
also necessary to eliminate any possible factors that can tax
the immune system, and maintain a healthy lifestyle involving
proper rest, moderate exercise, a balanced, nutritious diet (lots
of fruits, vegetables, whole grains, nuts, legumes, fish, and
reduced portions of red meat, poultry and dairy), and creative
outlets for relieving stress.
In my experience, many people afflicted with long-term peripheral
facial paralysis who have not improved after taking western drugs,
are then entered into programs that work to rehabilitate the facial
muscles. While these programs are effective to a certain extent,
incorporating traditional Chinese medicine on a regular basis
through acupuncture, cupping, and herbal medicine can significantly
improve results and help to resolve the condition. So for those
who are currently suffering from Bell's, don't give up hope!
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