Facial PHN

[AAF]

In late Dec.2109 I contracted shingles on the left side of my face, which despite antiviral medication transitioned to PHN.  Because of timing the antiviral, Valtrex, could not be adminstered until 8 days after the appearence of the rash on the left side of my chin, in my left ear and the upper left cheek.  We had been treating it with medications and recently with acupuncture.  The latter, so far, has not provided any relief.  I have observed, and reported to my neurologist, that when I lay down the pain eases considerably, but immediately starts when I stand up.  He was puzzled and could offer no explanation for this phenomenon.  Therefore, my question is do you have an explanation for this ?  Thank you for your help.

Albert Fournier,  aa_fournier***@****

[AAF]

Thank you for your response.   My condition began with scabs under the left side of my chin, next to my left eye and in my left ear and was diagnosed as shingles.  The initial pain was primarily in my ear, but then spread to other areas on the left side of my face.  I do have pain in my in the upper part of my jaw near the joint, but I don't have any of the other symptoms that you listed.  Could it still be Bell's palsy and why does the pain lessen when I lay down and resume when I stand?

[Dr. A. Srivastava]

Hi, Thank you for your question. From, your description of symptoms, it appears that you are experiencing unexplained one sided muscle weakness or paralysis of the face that is called Bell’s palsy (inflammation of 7th cranial nerve). Mostly it occurs after some viral infection, any neurological disorder, and head injury or in cancer. Other symptoms could be pain in jaw of the affected side, drooling of saliva, dropping of eyelid, ringing in the ear, headache, decreased sense of taste, difficulty with speech, and problems eating and drinking. Though it is not a life threatening condition, it is essential that a neurologist needs to be immediately consulted who would like to conduct electromyography (EMG test), nerve conduction studies and MRI to find out the extent and cause.  Most of the doctors suggest steroids, anti-retroviral medicines, botulism injection and physiotherapy to recover from the condition. Hope this helps.