Bell’s palsy – what are the signs and symptoms of Bell’s palsy?

Bell's palsy

Bell’s palsy

Introduction

Bell’s palsy is a condition that causes temporary weakness or paralysis of the muscles in one side of the face. It is the most common cause of facial paralysis.

Other causes of facial paralysis include:

congenital facial palsy – children born with facial weakness

injury to the facial nerve in an accident – such as a cut to the cheek or skull base fracture

injury from surgery – which is most common during surgery of the parotid gland and neck

What are the symptoms?

The symptoms of Bell’s palsy vary from person to person. The weakness on one side of the face can be described as either:

partial palsy, which is mild muscle weakness

complete palsy, which is no movement at all (paralysis) – although this is very rare

Bell’s palsy can also affect the eyelid and mouth, making it difficult to close and open them. In rare cases, it can affect both sides of a person’s face.

Read more about the symptoms of Bell’s palsy

When to seek medical advice

As well as being a symptom of Bell’s palsy, facial weakness or paralysis can also be a sign of a more serious condition – such as a stroke.

Visit your nearest A&E department immediately or call 999 for an ambulance if you or someone you are with develops sudden facial paralysis, so a doctor can determine the cause.

 

Bell’s palsy is only diagnosed if other possible causes of your symptoms are ruled out.

Read more about diagnosing Bell’s palsy.

Why does it happen?

Bell’s palsy is believed to occur when the nerve that controls the muscles in your face becomes compressed.

The exact cause is unknown, although it’s thought to be because the facial nerve becomes inflamed, possibly due to a viral infection.

The herpes virus is thought to be the most common cause but other viruses may also be responsible.

Read more about the causes of Bell’s palsy

Who is affected?

Bell’s palsy is a rare condition that affects about one in 5,000 people a year. It’s most common in people aged 15-60, but people outside this age group can also suffer from the condition. Both men and women are affected equally.

Bell’s palsy is more common in pregnant women and those with diabetes and HIV, for reasons that are not yet fully understood.

Treating Bell’s palsy

Around seven out of 10 people with Bell’s palsy make a complete recovery, with or without treatment.

Most people notice an improvement in their symptoms after about two to three weeks but a complete recovery can take up to nine months. The recovery time varies from person to person and will depend on the amount of nerve damage.

Prednisolone, a type of corticosteroid, is used to reduce the swelling of the facial nerve.

Eye drops may be required to prevent problems if you are unable to close your eye. Tape may also be used to close the eye while sleeping.

Read more about treatments for Bell’s palsy.

Complications

Around three in 10 people with Bell’s palsy will continue to experience weakness in their facial muscles, and two in 10 will be left with a more serious long-term problem.

Complications include:

persistent facial weakness

eye problems

difficulty with speech, eating and drinking

reduced sense of taste

facial muscle twitching

Bell’s palsy may reoccur in up to 14% of people, especially if there is a family history of the condition.

Read more about the complications of Bell’s palsy.

Acupuncture – Does it work? Read some of the evidence here

Acupuncture

Acupuncture

Have you ever used Acupuncture?

Did it work?  Tell us your view in the comments section below?

Acupuncture is a treatment derived from ancient Chinese medicine in which fine needles are inserted at certain sites in the body for therapeutic or preventative purposes.

It is often seen as a form of complementary or alternative medicine (CAM), although it is used in many NHS general practices, as well as the majority of pain clinics and hospices in the UK.

Theory

Western medical acupuncture is the use of acupuncture after a proper medical diagnosis. It is based on scientific evidence that shows the treatment can stimulate nerves under the skin and in muscle tissue.

This results in the body producing pain-relieving substances, such as endorphins. It is likely these substances are responsible for any beneficial effects seen with this form of acupuncture.

Traditional acupuncture is based on the belief that an energy, or “life force”, flows through the body in channels called meridians. This life force is known as Qi (pronounced “chee”).

Practitioners who adhere to traditional beliefs about acupuncture believe that when Qi does not flow freely through the body, this can cause illness. They also believe acupuncture can restore the flow of Qi, and so restore health.

Read more about what happens during acupuncture.

What is it used for?

Acupuncture practitioners – sometimes called acupuncturists – use acupuncture to treat a wide range of health conditions.

It is often used to treat pain conditions such as headache, lower back pain and osteoarthritis, but is also sometimes used in an attempt to help people with conditions ranging from infertility to anxiety and asthma.

Acupuncture is occasionally available on the NHS, although access is limited. Most acupuncture patients pay for private treatment.

Read more about the common uses of acupuncture.

Does it work?

Currently, the National Institute for Health and Care Excellence (NICE) only recommends considering acupuncture as a treatment option for chronic lower back pain, chronic tension-type headaches and migraines. NICE makes these recommendations on the basis of scientific evidence.

There is also some evidence that acupuncture works for a small number of other problems, including neck pain and post-chemotherapy nausea and vomiting.

Acupuncture is sometimes used for a variety of other conditions as well, but the evidence is not conclusive for many of these uses.

Read more about the evidence for and against acupuncture.

Having acupuncture

When it is carried out by a qualified practitioner, acupuncture is generally very safe. Some people experience side effects such as feeling drowsy or dizzy, but these are usually mild and short-lived.

If you choose to have acupuncture, make sure your acupuncture practitioner is either a regulated healthcare professional or a member of a recognised national acupuncture organisation.

Read more about acupuncture safety and regulation.

[Original article on NHS Choices website]

Evidence for and against acupuncuture

There is some scientific evidence acupuncture has a beneficial effect for a number of health conditions.

However, there is less clear scientific evidence about the benefits of acupuncture in the majority of conditions it is often used for.

The National Institute for Health and Care Excellence (NICE) only recommends considering acupuncture as a treatment option for chronic lower back pain, chronic tension-type headaches and migraine.

Assessing the evidence

One of the best ways researchers can assess the evidence behind a particular treatment is by carrying out a systematic review. This is a “study of studies” that combines findings from separate but similar studies to come up with an overall conclusion.

Systematic reviews are an important part of health research because they can identify findings that might otherwise be missed in individual studies. They can also help distinguish the effects of treatment from the effects of chance.

It is important to remember that when we use a treatment and feel better, this can be because of a phenomenon called the placebo effect and not because of the treatment itself. Systematic reviews can help reduce the potential influence of the placebo effect.

While systematic reviews cannot always determine conclusively whether a treatment does or does not work, they can be useful in assessing how a particular treatment (such as acupuncture) compares to another (such as “sham” acupuncture or medication).

However, even this can be challenging – both acupuncture and placebo treatments can stimulate the release of natural painkilling substances called endorphins, which can make it difficult to distinguish between them.

What evidence is there for acupuncture?

One of the largest and most respected organisations that carries out and publishes systematic reviews into the effectiveness of medical treatments is The Cochrane Collaboration.

A number of systematic reviews into the effectiveness of acupuncture have been published by The Cochrane Collaboration, and the basic results are summarised below.

Some positive evidence

Systematic reviews carried out by The Cochrane Collaboration have found there is some evidence acupuncture may have a beneficial effect on the following conditions:

However, because of disagreements over the way acupuncture trials should be carried out and over what their results mean, the existence of some positive evidence does not mean acupuncture definitely works for these conditions.

In many cases, the evidence appears contradictory. For example, some high-quality studies may suggest acupuncture is no better than “sham” acupuncture, whereas some lower-quality studies may suggest acupuncture is better than an established medical treatment.

The issue is sometimes also further complicated by the fact some “sham interventions” include active needling and are therefore not true placebos.

In addition, it can be difficult to make sure the patients involved in acupuncture studies are unaware of the specific treatment they are receiving (known as “blinding”).

This is because it is obvious whether you are receiving a conventional medical treatment such as medication or if you are receiving acupuncture, for example. This is a problem as it means the preconceptions of the person being treated may influence the result.

Some systematic reviews, however, have demonstrated the effects of acupuncture over sham treatment in studies where patients are unaware whether they are having real acupuncture or sham treatment.

For example, one large meta-analysis (a type of systematic review) not carried out by The Cochrane Collaboration included data from more than 17,000 patients. It compared acupuncture to sham acupuncture or no acupuncture without patients being aware of whether they had received real or sham treatment.

This review found acupuncture to be superior to both sham and no treatment for headaches, osteoarthritis, back pain and neck pain.

Little or no evidence

In many conditions where acupuncture is used, there is not enough good quality evidence to draw any clear conclusions over its relative effectiveness compared with other treatments.

For example, systematic reviews published by The Cochrane Collaboration have suggested more research is needed to assess whether acupuncture is effective for: asthmaglaucomaschizophreniadepressionshoulder, painelbow, painrheumatoid arthritisBell’s palsyrestless legs syndromeinsomnia vascular ,dementiastroke, stroke rehabilitation and swallowing problems caused by stroke

More research is needed to establish whether acupuncture is better or worse than best standard treatments for these conditions.

More information and research

If you want to find out more about studies into acupuncture, you can search for high-quality research using the NHS Evidence and Cochrane Library websites.

What You Need to Know about Botox – Infographic

What You Need to Know about Botox

What You Need to Know about Botox


Did you know that there were 4.8 million Botox procedures carried out in 2014, an increase of 748% from the beginning of the 21st century? While the vast majority of these were performed on women, there were still more than 640,000 procedures conducted of men, and 19,000 on teenagers, proving that the demographic interest for Botox is a lot more wide-ranging than you might think.

It is well known that Botox is an ideal method of facial rejuvenation, but it can also treat numerous medical conditions such as cervical dystonia, muscle contractures and bladder dysfunction. It has the potential to transform a person’s life, although it is not suitable for everyone – pregnant or breastfeeding women, people with Bell’s palsy and people with a coagulation disorder should not get Botox.

To learn more about Botox, including the steps in the procedure and some useful advice for before and after it, take a look at the infographic below from Dervla Leavy Dental Care  (www.dervlaleavydentalcare.com).

Difficulty swallowing? Find out how other people cope with Oropharyngeal dysphagia!

Difficulty swallowing Oropharyngeal dysphagia

Difficulty swallowing Oropharyngeal dysphagia

Swallowing disorders (or more properly called Oropharyngeal dysphagia) can occur at any stage of somebodies life. It can occur for a whole range of reasons and can even be hereditary! Oropharyngeal dysphagia is often associated with conditions like multiple sclerosis (MS), Parkinson’s disease, stokes, brain tumours, amyotrophic lateral sclerosis, Bell’s palsy, and myasthenia gravis.

In this post we are looking at the underlying causes of your swallowing problems, how they were treated and with what success.   It would be great if you could use the comments box below to share your Oropharyngeal dysphagia experience.

Current treatments include surgery, Palatal lift prosthesis, electrical stimulation as well as more general physiotherapy, using a bolus or just a change in diet.

So with that in mind we would like to think about some of the following questions about your swallowing difficulties:-

What was the cause swallowing problem?  Was it a medical issue?

What was the effect of swallowing difficulties on your lifestyle?   In particular how has it impacted your eating habits and diet?

What treatments for Oropharyngeal dysphagia did you receive and dis they actually work?

If you had to give one piece of advice for somebody who has just started to show signs of a swallowing disorder what would it be?

Thanks very much in advance.  It would be great if you could share this with other people who might be interested in sharing their experiences.

 

suzyqw I am seeing a speech pathologist. She has me doing all kinds of mouth & tongue exercises. She also taught me to turn my head to the side & point my chin down to make swallowing easier. That is what has helped me more than anything. I realize that it is common for us as ms patients. I don’t want more drugs to so call fix the problems. My food seems to get stuck in the middle of my throat. It’s random but I can tell when I start eating something if it will happen or not. I have also noticed it seems to intensify with hot foods. See a speech pathologist. They can help with swallowing.
fedupandconfused the most difficult thing is that just when you think you’ve finished with noticing things something else crops up and because its random you don’t know if it’s worth mentioning or even if it’s related and besides you don’t want to sound neurotic. I’ve not been diagnosed as yet but swallowing has been one of those things that seemed odd to keep happening. Initially i thought it was random but over the last year it’s progressed. The first time was when I ate a chunk of tuna and it got stuck I literally lost my breath and thought I would die. I was able to take a gulp of water down inbetween bringing bits back up. At the time I put it down to tuna being fairly dry. Then over time with various different foods on occasion I have managed to swallow but it felt like I’d got it stuck in my lungs and i haven’t been able to cough it up. And recently I’ve noticed I need to let my food completely cool down before I eat it which is strange as I’ve always eaten my food really hot. And now I have to let it cool down, eat a little bit, leave it then go back again when the last lot has gone down. I have also recently noticed when I swallow it seems to stick like a ball in my stomach or inbetween the osophegus and into the stomach. I find myself standing up to get it to “slide down” and once that ball/knot has gone I can start the whole eating process again. It could be coincidence and I never realised it’s another possible symptom til I saw this site.
[…] Since the dawn of humanity, one thing that motivates us on the basest level is eating. Early humans had to learn to hunt to put food in their mouths and stomachs. Modern men go through life, doing their jobs to earn the means to be able to put food on their plate. When it comes to the basic means of survival, being able to eat the food that we need in order to live is one of the very first ones that need to be met. And because this is a basic need, eating of course comes naturally to us. We eat everyday of our lives, from the very first moment we were born. Eating then involves digesting. The first process of digestion starts at the mouth, where food is ground and chew so it can be swallowed. Eating and even swallowing itself seems like such an inconsequential act, made so normally and so innocuously by every human being on earth. So what happens when a person has difficulty swallowing? […]
BonnieLass1 mj1daisy I wish I had a clue. Everyone’s MS is so different. I randomly just forget how to swallow. It’s strange that something that should be so natural suddenly becomes something you have to actually think about doing. I would say that your doctor or a second opinion would be the way to go. Some things are hard to explain when it comes to MS and weird symptoms like not being able to swallow. It is scary though and I always end up choking and throwing up because I can’t catch my breath when it happens. I wish you the best of luck.

mj1daisy I have difficulty with swallowing. It’s kind of sporadic with both solids and liquids. I had a barium swallow done and because I thought I just had acid reflux but it turned out to be “nonspecific motor in coordination of the esophagus” that was before I was diagnosed with MS so they went even ruling an MS symptom out. I wonder what they would say now???
It feels like a rock or somethings hard gets stuck and I have to stop swallowing for 30 seconds or more for it to stop hurting. Could it be esophageal spasms??
BonnieLass1 I have trouble swallowing but I have not received any treatment for it. Mine is MS relapse related and seems to happen randomly. I noticed that it was more when I was fatigued. I don’t have to be eating..I just forget to how to swallow. I panic normally then choke and throw up from it. Tears running down my face and gasping for air. Its something that I can’t seem to predict and normally when I am fatigued it happens more often. The higher dose of solumedrol that I am on the less it happens. Its something that I need to discuss in my next visit I am sure.