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Neurology (Expert Forum)
Ear pain - Craniotomy about a month ago
Answered by
CCFNeuroMD JT, MD - Neurology/Epilepsy, Neurology/General
Cleveland - OH
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury
Doctor's Answer
by CCFNeuroMD JT, MD, Oct 14, 2007 02:40PM
, Oct 14, 2007 02:40PM
To: hellokitty1
I am happy to address the questions that you pose, although it is important that you recognize that my impression is based entirely on the information you have provided in your posting and is by no means a substitute for an office visit with a neurologist. Diagnosis is contingent on detailed history and physical exam and as such, the following information should be considered solely for educational purposes.
As you are probably already aware, Bell’s palsy is characterized by unilateral facial paralysis which cannot be attributed to some other disease of the nervous system. The cause is variable but inflammation of the facial nerve secondary to viral infection (Herpes Simplex Virus, Herpes Zoster Virus, Epstein Barr Virus, Cytomegalovirus) is the most common. Although many cases are treated with prednisone and acyclovir (and antiviral), a surgical approach has been used in select patients. There has been some evidence suggesting that decompressive surgery is appropriate in patients with a 90% decrement in normal facial nerve activity on electrophysiologic testing, however pursuit of a surgical route remains a case-specific decision which is up to the neurologist and neurosurgeon’s discretion.
The prognosis for Bell’s palsy is generally good. Most patients will recover to their baseline level of facial nerve function, however between 5-35% (variable from study to study) will have some residual facial nerve deficits. The vast majority of patients will improve in three weeks time, however, some improvement may occur as far as 3-4 months after the initial onset.
As far as your pain is concerned, I am unable to comment as to whether this is the norm for the particular procedure you underwent as I am not a neurosurgeon. Should you still be experiencing discomfort within/around your ear, I would urge you to contact your surgeon. Thank you very much for your question, and I wish you the best of luck with your recovery.
As you are probably already aware, Bell’s palsy is characterized by unilateral facial paralysis which cannot be attributed to some other disease of the nervous system. The cause is variable but inflammation of the facial nerve secondary to viral infection (Herpes Simplex Virus, Herpes Zoster Virus, Epstein Barr Virus, Cytomegalovirus) is the most common. Although many cases are treated with prednisone and acyclovir (and antiviral), a surgical approach has been used in select patients. There has been some evidence suggesting that decompressive surgery is appropriate in patients with a 90% decrement in normal facial nerve activity on electrophysiologic testing, however pursuit of a surgical route remains a case-specific decision which is up to the neurologist and neurosurgeon’s discretion.
The prognosis for Bell’s palsy is generally good. Most patients will recover to their baseline level of facial nerve function, however between 5-35% (variable from study to study) will have some residual facial nerve deficits. The vast majority of patients will improve in three weeks time, however, some improvement may occur as far as 3-4 months after the initial onset.
As far as your pain is concerned, I am unable to comment as to whether this is the norm for the particular procedure you underwent as I am not a neurosurgeon. Should you still be experiencing discomfort within/around your ear, I would urge you to contact your surgeon. Thank you very much for your question, and I wish you the best of luck with your recovery.
If your nerve is still intact despite the inflammation / craniotomy, then you should expect recovery but it is unpredictable as even a regular Bell's palsy (which is still cause by inflammation) has a certain percentage that does not recover significantly ever.
It's too early to tell, see if anything happens in the next 3-6 months.