Facial paralysis 101: or, enduring Bell’s palsy

On September 29, 1999, I woke up and half my face didn’t work.

When I brushed my teeth, the water dribbled out. I couldn’t spit. My right eye hurt; it was dry. I tried to bare my teeth: one side grimaced, the other was slack. Raise my eyebrows? – Nope, raise a lone eyebrow. The affected one just sat, as did my right eyelid when I tried to blink.

Trying not to panic, I sat down to eat breakfast, only to bite my tongue and inner cheek in rapid succession. The mostly tasteless food became stuck between teeth and gums, and my tongue would not cooperate in clearing it out.

Standing next to the front door with my big barking dog felt as if I was in a jar with him, the din was so great and near. My own voice, by contrast, was slurred.

I had had no recent trauma. All day I fought the impulse to rush to the emergency room, though I asked myself, have you had a stroke?

No, this was my rude introduction to the world of Bell’s palsy.

One of my friends, a policewoman, was directing traffic in a chill wind when it struck her. Another friend awoke gripped by the unknown, as I did. I was “lucky” in that I was considered to have a mild case and could still speak; she, hysterical, called her mother, only to be hung up on several times because she couldn’t do more than grunt. She had to practice in the mirror for an hour before she finally managed to say “MA!”

Eastern schools of study, such as the Midwest College of Oriental Medicine in Chicago, say Bell’s is from a “wind strike” and/or an excess of the element wood (from Wood Becomes Water: Chinese Medicine in Everyday Life by Gail Reichstein). It turns out moms are right to bug us about donning warm coats, scarves, hats and gloves: the afternoon before I awoke paralyzed, I had been out without a winter coat or scarf; that evening, going back to the car, the weather changed to bitter and windy, my jacket collar of little help.

According to Western medicine, Bell’s is most often caused by having had one of the Herpes viruses (HSV-1), specifically cold sores, chicken pox, or shingles; it was in 85% of the patients studied according to the 8th International Symposium of the Facial Nerve, Matsuyama, Japan, 1997. Negligent for several weeks prior about taking my lysine, I had just had a cold sore, symptomatic of herpes simplex type 1. Chickenpox, too, is in the herpes family.

In neither discipline is it known who is most at risk for this intensely frustrating affliction (some people get colds sores all their lives but never Bell’s), how long an attack will last, what one might do to speed the healing, whether the entire range of motion will come back within 6 months, or how to avoid being one of the fewer than 10% who have a recurrence.

I located suggestions to use moist heat on the affected side; I used this daily along with self-massage techniques. I had chiropractic and acupuncture treatments the third day (the soonest I could be seen, having been stricken on a Saturday), electrical stimulation four times in the first two weeks, and acupuncture 2-3 times a week for the first three weeks. None of these are proven by formal studies to help, but in any event did me no harm. Some extra sleep was nice, but made no difference to my prognosis. Steroids such as Prednisone are prescribed in some cases, at a rate of 1mg/kg/day for 10-14 days, then tapering off, but studies have yet to say for certain that they help; I was glad no one recommended them for me. Surgery is reserved for the most severe cases: for instance, when the paralysis progresses instead of abates, if other facial nerves become involved, when there is no recovery in six or 12 months, some trauma cases. This, thankfully, was also not needed. I never did rush to the E.R.

The one universal caveat is serious attention to the eye, which must stay hydrated. I used the most gentle preparation I could find, before bedtime and naps, several times a night, and whenever I felt my eye becoming dry during the day. Since affected-side eyelids will be weeks in cooperating on their own, this meant a daily course of eyedrops and sleeping with a piece of plastic wrap held in place over the eye with hairnet tape, the standard recommendations. I didn’t find out about the plastic until my eye had already begun to close better. Don’t go for a pillow on your face or tape directly on the eyelid – this will probably serve only to waken you, as it did me, in extreme ocular discomfort: we weren’t designed to bear any pressure on our lids and eyeballs.

I had to take 2½ weeks off work, not so much because it looked gruesome, but because it became apparent that I couldn’t answer the phone with one hand, hold my eye closed with the other – and have a hand left with which to take notes!

During my recovery I researched the outlook. For the majority (86%) of sufferers the news is as good as it was for me; after 4-6 weeks the worst of it is over. Three months and now, years later, I am the only one who can tell that the very smallest movements in my face haven’t returned. I have not had a relapse.

So remember to get lysine, in your diet or supplementally, and nag the kids to bundle up their heads and necks when it’s cold out!


About majaramirez

former assistant instructor in tai chi chu'an; current TreeKeeper (#467); former Master Gardener; member of American Bird Conservancy, Audubon, Fraternal Order of Police, and Mensa; recently retired career cop; wife and mom.
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