BELL'S PALSY
Report #7229
You wake up one morning and find that on one side of your face, you can't smile, you can't close your eyelid and you can't raise your forehead. Sudden paralysis of the muscles on one side of your face is called Bell's palsy.
Your doctor should order tests for causes of nerve damage, such as vitamin B12 to rule out pernicious anemia, hemoglobin A1C for diabetes, antibodies for Lyme disease (1) or syphilis and even an MRI to rule out a tumor pressing on the nerve. Most doctors treat Bell's palsy with prednisone, even though no studies show that it is effective. A recent report in the Annals of Internal Medicine shows that more than 80% of the cases of Bell's palsy are caused by one group of viruses called herpes simplex (2). If you are not treated immediately, you have a 20% chance of having one side of your face paralyzed forever. On the other hand, if you take acyclovir, or one of the other drugs used to treat herpes simplex, as soon as possible, you will reduce your chances for permanent damage. All people who develop paralysis of the muscles on one side of their faces should start to take drugs to kill herpes virus immediately and get tests to find the cause.
1) SP Cook, KK Macartney, CD Rose, PG Hunt, SC Eppes, JS Reilly. Lyme disease and seventh nerve paralysis in children. American Journal of Otolaryngology 18: 5(SEP-OCT 1997):320-323.
2) S Murakami, M Mizobuchi, Y Nakashiro, T Doi, N Hato, N Yanagihara. Bell palsy and herpes simplex virus: Identification of viral DNA in endoneurial fluid and muscle. Annals of Internal Medicine 124: 1 Part 1 (JAN 1 1996):27-30.
Reported 9/30/97; Checked 9/5/05