is it MS

[tcm123]

Hi.  I have had bell's palsy more then 10 times in the last 2 years.  Had a mri done and two small spots showed up in the white matter of my brain.  I had a  lumbar puncture done, still waiting on the results.  Could many bell's palsy attacks be a sign for ms?  If not what could be causing so many attacks?

[SarahL2491]

I'm going to cut/paste Quix's reply to a similar question back in 2009 because I felt it was a good explanation.  Hopefully she will be flattered and not upset!

Well, first we need a little neuroanatomy lesson.

The cranial nerves seem like they should be peripheral nerves, because they show up out in the body, but in actuality all twelve cranial nerves are part of the central nervous system.  Steph is right.  They arise either from the brain itself or direct from the brain stem.  So all of the cranial nerves can be affected by MS.

Bell's Palsy is a problem with the Facial Nerve which is the 7th Cranial Nerve (CN VII).  This nerves main function is to drive the "muscles" of facial expression.  It is mainly a motor nerve.  When there is a Bell's Palsy on one side, that side of the face droops and sags and can't show expressions (similar to what a stroke looks like).  In general, it does not tingle or get numb, because those are effects from a problem with "sensory" (feeling) nerves.  The facial numbness and tingling is almost always a problem with the Trigeminal Nerve (CN V).  

The Trigeminal Nerve does not always cause Trigeminal Neuralgia when it is affected.  Sometimes it just causes decreased sensation.  And in people who have had TN, they are often left with decreased sensation after the TN resolves.  

Facial numbness is a common sign in MS.

Bell's Palsy is also common in MS, but is also very common in the healthy population so it does not point specifically to MS.  It can occur with viral infections, trauma to the TMJ, dental procedures and be idiopathic (the idiots don't know the pathology).

I have heard many doctors mix up Bell's Palsy with what is actually a problem of the Trigeminal Nerve, so the confusion is common.

Quix

[DiannaKw]

Based solely on personal experience, absolutely. My first MS exacerbation was initially diagnosed as Bells Palsy. It was only due to a subsequent MRI after the episode that I was diagnosed with MS. I have since had several flares, however none were ``bells palsy`` like in nature.