Bell's palsy (Facial paralysis)

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The disease named after Dr.Bell, is paralysis of facial (7th cranial) nerve. It is also called as facial paralysis. There is deviation of eye and mouth. Mostly this disease occur in the age group of twenty to forty.


Etiology


According to modern medicine this condition is believed to be an inflammatory lesion in the stylomastoid canal, the paralysis being due to compression of the nerve fibres by oedema. Viral infection, vascular damage, trauma and cold exposure are possible causes. According to TCM it is due to paralysis of the facial muscles caused by the attack of pathogenic wind and cold on stomach, Large intestine, Gall bladder & Triple warmer meridians, leading to malnutrition of the muscle regions of the meridians.


In Chinese, feng means wind. Pathogenic wind attacks the body through feng points e.g.


Fengfu Du 16

Fengchi GB 20

Yifeng TW 17

Fengmen UB 12

Fengshi GB 31

Bafeng Ex 36


Cold draught blowing on these points leads to this disease.


Clinical features


The onset is sudden or sub acute with symptoms coming on over a few hours or it may be sudden after waking up or travelling in cold weather. There may be pain in the face or around the ear prior to loss of movements on one side of the face. Tongue may have tingling sensation on the affected side with loss of taste sensation on the anterior 2/3rd of the tongue. In severe lesions there may be loss of salivation and tear secretion. There is paralysis of muscles on one side of the face with failure to close the eye and visible upward deviation of the eye (Bell’s sign). The mouth is drawn over to the normal side with dribbling salivation. The tongue may appear deviated to normal side. There may be partial dysarthria. Patient is unable to raise the eyebrow to close the eye on the affected side. He can’t whistle. While blowing air, the air will be blown out only from the normal side. If he is asked to show the teeth, teeth are seen only on the normal side as the angle of mouth on the affected side doesn’t open up. In facial paralysis due to upper motor neurone lesion e.g. Hemiplegia, the fore head is unaffected so the patient can raise the eyebrow of the affected side.

   

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