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Bell's Palsy

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Dear Dr. Levister: I was diagnosed with Bell's palsy. To my shock and horror I awoke one morning to find the left side of my face distorted. My speech is also slurred. I'm 20 years old and in good health. What causes this condition, and what are my recovery chances? Bombed out!

Dear Bombed Out: Sudden paralysis of one side of the face can be very upsetting not to mention a real blow to one’s personal vanity. However, early treatment with antiviral medications and corticosteroids may improve the chances for full recovery. Bell's palsy is the sudden partial or complete paralysis of one side of the face. Palsy is the medical term for partial or complete paralysis; Bell's comes from Sir Charles Bell, the 19th century Scottish physician who first described the anatomy and function of the facial nerve.

Symptoms include a sagging eyebrow, an inability to close one eye completely, and the mouth being drawn toward the unaffected side of the face. Some people have decreased tearing and a loss of taste on the same side of the tongue as the palsy. Onset in just a day or two is one of the hallmarks of the condition. Bell's palsy distorts the face, makes it difficult to eat with the mouth closed and slurs the speech. But about 70% of patients have full recovery within months and about 15% have minor, residual weakness.

About 40,000 Americans come down with this condition each year. Teenagers and people in their 20s and those over age 60 seem to be most vulnerable. People with diabetes are four to five times more likely to get Bell's palsy. About 8% of patients report a family history of Bell's palsy, but it's unclear if the disease has a genetic basis.

Most cases of Bell’s palsy occur when a branch of the facial nerve becomes inflamed. The cause of the initial inflammation has been a big mystery. Now doctors believe that in most cases it‚s triggered by an infection of the facial nerve by herpes simplex virus, the same virus that causes cold sores. Other infectious diseases -- including Lyme disease and, rarely, HIV may cause sudden facial paralysis.

In most cases, no diagnostic tests are needed. You should, though, be tested for Lyme disease if you live where the disease is common. Injured or inflamed facial nerves have a remarkable ability to heal, which is why most people will recover without medications. Even so, it’s now standard practice for all patients to get a strong anti-inflammatory corticosteroid like prednisone and an antiviral medication like alacyclovir. Starting treatment within two or three days after symptoms first appear will greatly improve the chances for full recovery.

Dr. Levister welcomes reader mail concerning their body but regrets that he is not able to answer individual letters. Your letters will be incorporated into the column as space permits. You may direct your letters to Dr. Levister in care of Black Voice News, P.O. Box 1581, Riverside, CA 92502.

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