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Etiology

Unilateral facial weakness is a common neurologic sign. Many disorders can affect the facial nerve and cause facial weakness, among them, Bell's palsy is the most common one. Bell's Palsy is a unilateral facial paralysis of sudden onset and idiopathic virus attack on the facial nerve, this virus is more often Herpes Simplex-1 Virus (known as HS1).  The most common causes of facial paralysis are as follows:

o        Virus infections: HS1, shingles, varicella, etc.

o        Bacteria infection of ear, noses, throat and gum.

o        Tumor

o        Trauma

o        Neurologic condition: Gullian-Barre Syndrome.

o        Metabolic: pregnancy, diabetes, hyperthyroidism, hypertension.

o        Toxic: alcoholism, thalidomide, tetanus, carbon monoxide.

o        Exposure to wind & cold in Chinese medicine.

o        Immune diseases.

Pathologic changes in Bell's palsy: Swelling of the nerve with ischemia and compression of the facial nerve in the narrow confines of its course through the temporal bone.


Clinical Features

The paralysis is usually unilateral but may be bilateral involvement. Most paralyses are a once in a lifetime event, however 7% of the patients may experience multiple attacks. The most common symptoms are:

o        Asymmetrical Smile

o        Synkinesis

o        Tearing or dry eye

o        Inability to close eye

o        Abnormal blink

o        Inability to whistle or pucker lips

o        Frozen nasalis muscle in area of nostrils

o        Buccinator paralysis (food caught in cheek of paralyzed side), inability to "puff" one's cheeks

o        Drooling of liquids from corner of paralyzed mouth

o        Hyperacussis (perceiving sounds as unduly loud)

o        Excessive perspiration

o        Weakened facial musculature

o        Lack of wrinkling on forehead of paralyzed side

o        Change in taste

o        Changes in speech

o        Tightness / swelling of facial muscle

o        Facial pain

o        Acoustic pain


Diagnosis

o        Abrupt-onset of the weakness of the entire half of the face is easily diagnosed Bell's Palsy.

o        Facial weakness caused by some other disorders has to be differentiated by the lab tests, CT or MRI scans.

Traditional Chinese Medicine differentiates Bell's palsy into three types:

o        Wind cold, the most common type

o        Toxic heat

o        Deficiency


Differentiation

o        Stroke or tumor: the  facial weakness is partial, usually with one side extremity weakness.


Treatment

First Two Weeks (Gold Recovery Stage): Herbal medicine therapy, our Bell's Palsy Herbal Formula decreases the facial nerve inflammation, enhances the immune system and fight the virus. In Xi'an China, the standard treatment: in Bell's palsy Specialty Clinic are: 80mg prednisone 7 days and gradually decrease over the 14 days; antiviral or antibiotic medications; Bell's Palsy Herbal Formula; light acupuncture treatment; tape the eye lids and wear mask. The cure rate is above 95%.

Second Two Weeks (Silver Recovery Stage): 
Bell's Palsy Herbal Formula, acupuncture with light electrical stimuli, and antiviral or antibiotic medications; tape the eye lids and wear mask. The Cure rate is above 90%.

Third Two Weeks to Three Months (Bronze Recover Stage): 
Bell's Palsy Herbal Formula, acupuncture with electrical stimuli, Tuina and Qi Gong exercises, tape the eye lids at night. The cure rate is above 85%.

After Three Months: 
Bell's Palsy Herbal Formula II, acupuncture with electrical stimuli, Tuina and Qi Gong exercise. For those who never get prednisone therapy, there may be a 10 days 80mg prednisone treatment along with 45 days of Bell's Palsy Herbal Formula II. The cure rate is 50%. From here, you may notice how important it is to get the right treatment at the early stage. Please be sure to consult your physicians for the use of medications like prednisone, antiviral or antibiotic medications.

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