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Neurology (Expert Forum)
Can it effect me twice within a month?
Answered by
Lama Chahine, MD - Neurology
Cleveland Clinic
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.
Can it effect me twice within a month?
by Tuck24, Nov 19, 2008 08:31AM
I woke with Bell's Palsy 3 weeks ago today' went to the E.R. had every scan and all the bloodwork done. I had a really bad migraine a week earlier and still have it. It has not gone away and today I wake up and have the same pain in my other ear and I feel like its gonna happen on that side and my right side is just starting to show a little improvement. I finished all my meds this morning and I'm worried I'm in for round 2. Can you shed some light please.........Thank You, Vance.
Doctor's Answer
by Lama Chahine, MD, Nov 22, 2008 06:01PM
, Nov 22, 2008 06:01PM
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.
Without the ability to examine you and obtain a history, I can not confirm whether or not you have Bell's palsy nor whether or not it is occurring again on the other side. However, I will try to provide you with some information.
There are 12 nerves, called cranial nerves, that supply our face. One of these nerves is called the 7th cranial nerve, of facial nerve. It innervates several parts of the face, including the muscles we use for facial expression (smiling, closing the eyes, looking surprised). It also has such functions as helping us perceive taste on part of our tongue, and dampens sounds so that they are not too loud. It is also involved in our eyes tearing and in our mouth watering.
Bell's Palsy is a condition that results from a lack of function of the facial nerve, and the problem leading to this dysfunction can be anywhere from the origin of the nerve to anywhere in its path where it gives of smaller nerves to supply all the areas described above.
It could be "idiopathic", meaning having no known, identifiable cause, or secondary to other processes, including but not limited to infections (such as Lyme disease or Herpes infection) or inflammation (such as in the condition called sarcoidosis). If it is isolated, meaning that no other findings are present, then it is highly unlikely to be due to a stroke, tumor, or other causes. However, if for example, the body on the side opposite of the facial weakness is also weak, the latter causes need to be ruled out.
A recent study showed that treatment with a type of steroid called prednisone for 10 days helps the nerve recover function. Until the eye can be closed properly, natural tears and ointment should be applied to the eye to protect it.
The extent of recovery will depend on the cause, and the age of the patient. In idiopathic cases in younger individuals, complete or near complete recovery of the function of the facial nerve over weeks to 2-3 months is expected. In some cases, there is partial recovery, and much less commonly, there is little recovery of function.
If Bell's palsy occurs on both sides of the face within a certain time period, a cause should be searched for. Specifically, HIV, a condition called sarcoidosis, Lyme's disease, and other infections need to be excluded. Associated ear pain may imply a viral cause such as herpes or other viruses.
I suggest you follow up closely with your primary care/family physician if you feel you are developing Bell's palsy on the other side of your face as further testing may be indicated.
Thank you for this opportunity to answer your questions, good luck.
Without the ability to examine you and obtain a history, I can not confirm whether or not you have Bell's palsy nor whether or not it is occurring again on the other side. However, I will try to provide you with some information.
There are 12 nerves, called cranial nerves, that supply our face. One of these nerves is called the 7th cranial nerve, of facial nerve. It innervates several parts of the face, including the muscles we use for facial expression (smiling, closing the eyes, looking surprised). It also has such functions as helping us perceive taste on part of our tongue, and dampens sounds so that they are not too loud. It is also involved in our eyes tearing and in our mouth watering.
Bell's Palsy is a condition that results from a lack of function of the facial nerve, and the problem leading to this dysfunction can be anywhere from the origin of the nerve to anywhere in its path where it gives of smaller nerves to supply all the areas described above.
It could be "idiopathic", meaning having no known, identifiable cause, or secondary to other processes, including but not limited to infections (such as Lyme disease or Herpes infection) or inflammation (such as in the condition called sarcoidosis). If it is isolated, meaning that no other findings are present, then it is highly unlikely to be due to a stroke, tumor, or other causes. However, if for example, the body on the side opposite of the facial weakness is also weak, the latter causes need to be ruled out.
A recent study showed that treatment with a type of steroid called prednisone for 10 days helps the nerve recover function. Until the eye can be closed properly, natural tears and ointment should be applied to the eye to protect it.
The extent of recovery will depend on the cause, and the age of the patient. In idiopathic cases in younger individuals, complete or near complete recovery of the function of the facial nerve over weeks to 2-3 months is expected. In some cases, there is partial recovery, and much less commonly, there is little recovery of function.
If Bell's palsy occurs on both sides of the face within a certain time period, a cause should be searched for. Specifically, HIV, a condition called sarcoidosis, Lyme's disease, and other infections need to be excluded. Associated ear pain may imply a viral cause such as herpes or other viruses.
I suggest you follow up closely with your primary care/family physician if you feel you are developing Bell's palsy on the other side of your face as further testing may be indicated.
Thank you for this opportunity to answer your questions, good luck.
