September 2008

Bell's Palsy (Temporary Facial Paralysis)

By Elliot Wagner, O.M.D., L.Ac., Doctor of Oriental Medicine

I was prompted to write about Bell's palsy after one of my patients told me how her daughter, a teacher, had awakened one morning to find her face suddenly disfigured, and feared she had had a stroke.After a frantic trip to the doctor, she found out that her problem was Bell's palsy, and that the paralysis was temporary. Her problem then became how to explain her crooked smile to her new fall students.

If you have ever had Bell's palsy, or temporary facial paralysis, you know what a distressing problem it can be. My grandfather, when he was making his way from the Ukraine to New York, was one of many emigrants in an open third-class train that was traveling across central Europe. After a night of standing in the open air, he noticed that his face felt stiff. Looking at his reflection in a train window, he was shocked to see that one side of his face had fallen. When he attempted to speak,he found he could not pronounce certain words. He was a young man at the time, without resources, and without even the local language to be able to inquire about his condition. After a few weeks the stiffness diminished, and he was able to speak normally, though a small amount of the original stiffness, as well as a slightly drooping left eyelid, stayed with him for years.

Bell's Palsy comes on suddenly, causing distortion of facial features and interfering with normal functions such as closing the eyes, chewing, and eating. There may be pain or tingling in the face and in, or behind, the ear. Because of the sudden paralysis, patients often fear that they have suffered a stroke, though Bell's Palsy is not related to stroke. This form of facial paralysis is most often caused by one of several viruses, most commonly either herpes simplex-1 (that also causes cold sores and genital herpes) or herpes zoster (the shingles virus), that attack one of the principal nerves in the face.

If you read the online chats, you will come away understanding what unhappiness this condition causes when it is not dealt with effectively. The bad news is that lasting paralysis can and does occur. I had one patient who did not heed my advice to get immediate care and ended up with a badly distorted mouth. Several years later she was still unable to smile or fully close one eye. The good news is that three-quarters of the time the problem resolves itself within a few weeks to a few months, and most patients have few or no signs after a year.

If you have an episode of Bell's Palsy, the best way to prevent lasting problems is to begin care within 72 hours. The most widely accepted medical protocol is an oral steroid such as prednisone, and some physicians also recommend an anti-viral, such as acyclovir, although a recent large study showed no help over a steroid alone.

I am an acupuncturist and herbalist, and I would not be writing this if I had not seen patients get better with the help of acupuncture. In Chinese medicine, Bell's Palsy is considered to be caused by an acute attack of wind and cold. The treatment is directed toward removing the wind from the channels and warming, strengthening, and moving the energy.

Acupuncture is effective treatment for Bell's palsy in four instances:

  1. Even for patients who take steroid medications, acupuncture is powerful support, and speeds the healing of pain, stiffness, and function. This is particularly helpful for older patients.
  2. For patients who do not want or cannot take steroid medications, acupuncture is a very effective course of treatment, if started immediately.
  3. For patients who have had a past episode, acupuncture helps healing even though the optimal time for treatment has passed.
  4. Lastly, acupuncture does what medications cannot do: strengthens the body to help prevent relapse. Once again, this is very important for older patients.