Because of possible drug interactions, individuals taking prescription medicines should always talk to their doctors before taking any over-the-counter drugs. Another important factor in treatment is eye protection. Bell's palsy can interrupt the eyelid's natural blinking ability, leaving the eye exposed to irritation and drying. Keeping the eye moist and protecting it from debris and injury, especially at night, is important.
Lubricating eye drops, such as artificial tears or eye ointments or gels, and eye patches are also effective. Other therapies such as physical therapy, facial massage, or acupuncture may provide a potential small improvement in facial nerve function and pain. In general, decompression surgery for Bell's palsy—to relieve pressure on the nerve—is controversial. On rare occasions, cosmetic or reconstructive surgery may be needed to reduce deformities and correct some damage such as an eyelid that will not fully close or a crooked smile.
The prognosis for individuals with Bell's palsy is generally very good. Clinical evidence of improvement occurs spontaneously within three weeks in 85 percent of cases, and most individuals eventually recover normal facial function. Some individuals may be left with mild residual facial weakness or show moderate to severe deficits. The mission of the National Institute of Neurological Disorders and Stroke NINDS is to seek fundamental knowledge about the brain and nervous system and to use the knowledge to reduce the burden of neurological disease.
The NINDS conducts and supports an extensive research program of basic science to increase understanding of how the nervous system works and what causes the system to sometimes go wrong, leading to dysfunction. Part of this research program focuses on learning more about the circumstances that lead to nerve damage and the conditions that cause injuries and damage to nerves. For example, in one research project, scientists are studying two genes to identify the molecular mechanisms involved in the regeneration of nerve projections axons to their original targets.
An understanding of how to regenerate peripheral nerves may lead to ways to prevent nerve damage and injuries from occurring. It is less common before age 15 or after age Bell's palsy is not considered permanent, but in rare cases, it does not disappear. Currently, there is no known cure for Bell's palsy; however, recovery usually begins 2 weeks to 6 months from the onset of the symptoms.
Most people with Bell's palsy recover full facial strength and expression. The cause of Bell's palsy is not known. It is thought that it may be due to inflammation that is directed by the body's immune system against the nerve controlling movement of the face. Bell's palsy is sometimes associated with the following:. The symptoms of Bell's palsy may look like other conditions or medical problems. Always see your healthcare provider for a diagnosis.
However, your healthcare provider may order tests to rule out other conditions that can cause similar symptoms and to determine the extent of nerve involvement or damage. These tests may include:. Otherwise, the symptoms are treated as needed. One uniformly recommended treatment for Bell's palsy is protecting the eye from drying at night or while working at a computer.
Eye care may include eye drops during the day, ointment at bedtime, or a moisture chamber at night. Skip to content. Bell's palsy is an unexplained episode of facial muscle weakness or paralysis that begins suddenly and worsens over three to five days.
This condition results from damage to the 7th facial cranial nerve, and pain and discomfort usually occurs on one side of the face or head. It can strike anyone at any age, but it occurs most often in pregnant women, and people who have diabetes, influenza, a cold or another upper respiratory ailment. Bell's palsy strikes men and woman equally.
It is less common before age 15 or after age Bell's palsy is not considered permanent, but in rare cases it does not disappear. Currently, there is no known cure for Bell's palsy; however, recovery usually begins two weeks to six months from the onset of the symptoms. Otic involvement may include tinnitus, deafness, or sounds being louder hyperacusis. Some patients are also bothered by dizziness and inability to maintain normal balance.
Furthermore, the degree to which pharmacologic agents improve the condition is unknown. Nevertheless, corticosteroids are often prescribed in the hope that they will decrease inflammation of the facial nerve, improve function, and decrease recovery time.
One regimen is prednisolone 50 mg daily for 10 days. Another is prednisone 60 mg daily for 5 days, subsequently reducing the dose by 10 mg each day for the next 5 days. Antiviral medications with activity against herpes simplex virus have also been used in some patients, with mixed results. However, there may be a small benefit in adding antiviral agents to corticosteroids in patients with severe facial palsy.
The optimal doses and regimens are not clear, but valacyclovir 1 g three times daily and acyclovir mg five times daily are commonly administered in studies. Both antivirals are typically well tolerated, with gastrointestinal issues such as nausea, vomiting, and diarrhea being the most common adverse effects. For daytime treatment of dry eye, the pharmacist has numerous choices of eye drops and gels.
Safe and effective FDA-approved ingredients include celluloses, polyvinyl alcohol, glycerin, etc. Patients should instill drops in the eye as needed during waking hours. The patient should then use one hand to gently and completely pull the upper eyelid down to meet the lower eyelid. If the eye is not taped shut, it will dry despite application of ointment.
When selecting a dry eye drop, patients should be advised to avoid Rohto, as it contains menthol, which can irritate the eye. Dry Mouth: Counseling patients regarding treatment of dry mouth is simpler than dry eye.
Products available were not reviewed by the FDA, but seem to be effective. They include Salivart, Biotene, and MouthKote. Patients can be advised to use them liberally, as often as needed. Cheek Injuries: An accidental bite of the cheek is a painful intraoral wound. Pharmacists can advise patients with either type of intraoral wound to use two groups of products.
The first is intended to cleanse the wound. These products contain carbamide peroxide e. Oral Hygiene: Inability to clear the buccal pouches of food facilitates growth of the oral microbiota. As time passes, a film of plaque covers tooth surfaces. Eventually, it develops into a solid material known as plaque or tartar. Plaque is responsible for caries and gingivitis, and it can lead to periodontal disease and tooth loss.
Xerostomia also increases the risk of caries, since saliva raises the oral pH, reducing acidic degradation of dental enamel. Following each meal or snack, the patient must dislodge food particles from crevices by rinsing thoroughly.
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