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| Neurological 1:facial paralysis |
A: In my experience ,first, it is a must to diagnose that it is lower motor neuron lesion or upper motor neuron lesion(UMN). although the most common cause of facial paralysis is Bell's palsy,we need to rule out other causative factors for facial paralysis including those that affect the central nervous system such as cerebrovascular accidents (stroke) and intracranial tumours. This can be determined through my physical exam and brain CT or MRI.
Bell's palsy is an idiopathic "viral" attack on the facial nerve occurring in approximately 11 persons out of 10,000. The virus most commonly associated with Bell's palsy is the Herpes Simplex-1 Virus (known as HS1)。
Symptoms including, but not limited to:
Lack of wrinkling on forehead of paralyzed side
• Inability to close eye> Tearing or dry eye, Abnormal blink
• Frozen nasalis muscle in area of nostrils
• Buccinator paralysis (food caught in cheek of paralyzed side), inability to "puff" one's cheeks
• Inability to whistle or pucker lips
• Drooling of liquids from corner of paralyzed muscle.
• Weakened facial musculature
• Asymmetrical Smile,
skynesis
• Hyperacussis (perceiving sounds as unduly loud) : a suggestive of a lesion proximal to the middle ear, affecting the nerve to the stapedius.
• Excessive perspiration
• Change in taste : anterior two-thirds of the tongue.cranial nerve VIII lesion proximal to the middle ear will cause loss of taste.
Changes in speech
• Tightness / swelling of facial muscle
• Facial pain
• Acoustic pain
Treatment therapies involve the use of acyclovir or Valtrex (an anti-viral drug for targeting the herpes viruses), prednisone (which blocks immune function to prevent inflammation of the affected nerve and surrounding tissue), and corticosteroids (for reducing inflammation around the nerve and any pain associated with the inflammation). The prognosis for Bell's palsy ranges from complete recovery within a few weeks (85% of patients) to chronic symptoms of facial paralysis (15% of patients)
In Traditional Chinese Medicine, this condition is due to pathogenic wind-cold attacking the Shaoyang (Liver, Gall Bladder) and Yangming (Stomach, Large Intestine) channels as well as the tendons and muscles. This can occur when a patient is exposed to wind (e.g.sleeping near an open window, driving with the windows down, going on a boat when the winds are strong) and is more common in the spring and autumn months. Often people with Bell's palsy have a deficient immune system (possibly due to genetics, unresolved or chronic illness, improper diet, rest, exposure to toxic chemicals or drugs, or undue physical and emotional stress). As a result, they are more vulnerable to outside sources such as further exposure to physical and emotional stress factors or viral and bacterial pathogens. The exposure to the external source causes the immune system to produce an inflammatory response in the affected region resulting in swelling of the surrounding tissues. This swelling can then obstruct the normal function of the nerves and vessels (ie. the facial nerve). As a result, there is an obstruction of qi (vital energy) and blood in these areas that leads to malnourishment of the tendons and muscles and thus a propensity for the facial muscles to become lax or paralyzed. The lack of nourishment to the local area can therefore cause symptoms of numbness and tingling, which are common signs of qi and/or blood deficiency in TCM (Traditional Chinese Medicine).
Acupuncture can help to move the blood circulation and energy to the affected site to help restore function, strengthen the muscle strength and also has immune enhancing effects, it is really good in the treatment of peripheral facial paralysis for a faster and complete recovery.
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Posted by ChenYang on 2009-03-08 20:01:44 | Rating: | Views: 23
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