Six years ago this Friday, WIS’ Mary King went from reporting the news on a Friday morning, to having complete paralysis on the right side of her face by that night.
A trip to the ER would rule out a stroke, but it introduced her to the words - Bell’s Palsy.
In sharing her journey then, she quickly heard from people all over the world who had or were experiencing Bell’s Palsy, and she has continued to receive emails to this day.
However, six years later, doctors rarely pinpoint exactly what causes the condition, and there’s no definite cure. She took those questions to local doctors where she also learned why we still don’t know a lot about the condition. She also learned that because she’s pregnant, her odds of getting the condition are possibly even greater than before.
“The symptoms start very suddenly, and they should reach their maximum within the first three weeks,” Dr. Katie Dahlburg said. The Lexington Medical Center Neurologist was examining pictures of King’s episode with Bell’s Palsy which started June 1st in 2012.
“We see kind of what we expect to see here, the smile is a little more crooked here and there's a little less movement in the face,” she said pointing to the picture of King taken seven days after the onset of her Bell’s Palsy.
But for each of the 40,000 Americans affected each year, what causes the 7th cranial nerve to be damaged and the extent of facial paralysis can be different.
“The facial nerve travels from the back of the brain or your brain stem, up through your face to provide the muscle tone and movement in your face,” Dr. Dahlberg said. “It's just a very tiny isolated nerve and when that's affected (inflamed or compressed) by a virus or inflammation or infection it can react in a way that causes it to not function appropriately.”
King was less than two months from her wedding day when she experienced facial paralysis and was diagnosed, and she would quickly learn there’s no cure or quick fix, just treatments doctors hope will be effective. The same is still true today.
“The treatments for Bell’s palsy are most effective within the first three days of your symptoms beginning,” said Dr. Dahlburg. “Mainstay treatments are oral steroids like prednisone because there is a thought that viruses may contribute to Bell’s Palsy and in some cases and especially more severe cases an anti-viral will be used in addition to the steroids.”
So why six years later is there still not a lot known about the cause of the condition?
“There is still research going on for Bell’s Palsy, but it is limited because in the world of neurological illness, there are so many things that are potentially fatal or life-limiting,” said Dr. Dahlburg. “So a lot of the resources are funded to that direction. But there are certainly still studies going on to better understand what causes Bell’s Palsy and what may predispose certain people to the condition."
While Bell’s Palsy doesn’t discriminate, people with diabetes are more likely to get it. At King’s latest checkup appointment for her pregnancy, she also learned pregnant woman are three times more likely to get the condition.
“When your blood volume goes up, it goes up everywhere, so pretty much everything gets swollen when you're pregnant, including nerves around your face,” said Dr. Douglas Addy, an OBGYN with Lexington Medical Center.
In addition to pregnancy and diabetes, other possible triggers for the condition are a viral infection like the cold sore virus, the flu or flu-like illnesses, headaches, high blood pressure, Lyme disease and other traumas according to the National Institute of Neurological Disorders and Stroke.
The institute also provides a list of symptoms that can vary person to person and range from mild weakness to total paralysis. It may also include drooping of the eyelid and corner of the mouth, drooling, impairment of taste, excessive tearing in one eye, ringing in one of both ears, pain or discomfort behind the ear and around the jaw, loss of taste, impaired speech, dizziness and difficulty eating or drinking.
While there’s no way to know if you’ll get Bell’s Palsy or any way to prevent it, doctors say if it does happen, the best thing to have is hope.
“You try just not to worry about it, but that's obviously difficult to do,” Dr. Addy said.
“It is a time-limited process, and it will more than likely improve with time, but certainly remember if you're not seeing any improvement whatsoever between the first 4 to 6 months to see a neurologist just so we can determine if there something else going on,” Dr. Dahlburg said.
Ultimately, doctors say they tell patients to give themselves about 3 months for recovery.
But doctors say to keep in mind when a nerve is damaged it may never fully recover. In King’s case, when she’s tired or stressed, she says she can tell it takes more effort to utilize the muscles on the right side of her face and doctors say that’s normal.
Some people who have been diagnosed with Bell’s Palsy ask about the effectiveness of alternative therapies.
“Acupuncture is a possibility,” Dr. Dahlburg said. “I always say with the alternative therapies like that, there's no harm and worst case scenario it doesn't make a difference and best case scenarios is you get some improvement.”
Dr. Dahlburg said for those who never see recovery, there are some more options as well. “There are some new therapies emerging where we can use things like Botox to achieve more symmetric facial expression and also for people who are having difficulty closing their eyes, physicians can insert a little bit of weight in the eye lid so someone can have more function there.”
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