Bell’s Palsy – General Recommendations
Bell’s palsy is an inflammatory process affecting the seventh, or facial cranial nerve, which controls function of our many facial muscles that allow us to smile, help us chew, and help us blink our eyes. We actually have two of each of the 12 cranial nerves, including the facial nerve, one on each side.
With inflammation, the nerve canal for the facial nerve swells, putting pressure directly on the nerve itself. In turn, nerve transmission slows and the muscles in the target area lose their stimulus to contract. Over time, the muscles, lacking signals to contract, become flaccid, or technically, atrophied, so that asymmetry becomes evident in the facial expression. Usually, the inflammation occurs only on one side, leading to facial or eyelid drooping, even changed speech.
Fortunately, Bell’s palsy generally affects only the motor nerves regulating muscle contraction, not the sensory tracts that carry pain impulses, so rarely do patients suffer pain. Trigeminal neuralgia on the other hand, an inflammation of the 5th or trigeminal nerve that transmits sensory impulses from the face, has long been associated with relentless, devastating pain.
Researchers link Bell’s palsy most commonly to a viral infection, particularly Herpes Simplex Type 1, the cause of more mundane cold sores in our mouth. Herpes Zoster, the cause of chicken pox and shingles, has also been associated with the problem. All Herpes viruses live in the nerve cells and if during active infection, the virus should invade the 7th nerve and persist, inflammation ensues and the palsy develops. Usually, Bell’s palsy is self-limited, meaning it resolves on its own, and the muscles regain their function and strength.
A number of unconventional treatments, such as acupuncture can help. I find that injectable vitamin B12, either in the hydroxy or methyl form, can help, in the dose of one milligram daily for two weeks, followed by twice weekly until the problem resolves. I also recommend B1, or thiamine, in the dose of 100 milligrams daily for two weeks, then twice a week. Both B12 and B1 should be administered subcutaneously, with a small needle to minimize discomfort.
Studies going back to the 1950’s suggested that these two nutrients in injectable form reduce swelling and inflammation in nerves and reduce pain. Researchers proposed the treatment initially for trigeminal neuralgia, and in my experience, the vitamins work when all other approaches fail. I have also found the two nutrients useful for Bell’s palsy, which like trigeminal neuralgia, is basically an inflammatory response around a cranial nerve. In my practice, they work very well and usually rapidly in terms of inflammation, though with Bell’s palsy, the muscle atrophy improves gradually.
With my patients, including those diagnosed with Bell’s palsy, I always prescribe a full nutritional program involving individualized diet, individualized supplement protocols and detoxification routines, but acupuncture, B12 and B1 are a good start.
By Nicholas Gonzalez, M.D.