Understanding Facial Palsy: Causes, Symptoms, Treatment, and Recovery

Facial palsy, often referred to as Bell's palsy, can strike suddenly and leave individuals feeling bewildered. In this comprehensive guide, we'll delve deep into the world of facial palsy, shedding light on its causes, symptoms, treatment options, and the road to recovery. So, let's embark on this journey to demystify facial palsy together.

What is Facial Palsy (Bell’s Palsy)?

Facial Palsy/Bell’s Palsy is a condition that leads to a sudden, temporary weakness or paralysis of the muscles on one side of your face. Imagine waking up one morning and finding that you can’t smile, wink, or even sip your coffee properly—freaky, right? Well, that’s the grim reality for those hit by this condition.

Causes of Facial Palsy

Facial palsy can be attributed to various factors, including:

1. Viral Infections: Most commonly, facial palsy is linked to viral infections, particularly the herpes simplex virus.
2. Inflammation: Inflammation of the facial nerve can also result in Bell’s palsy.
3. Stress and Immune Response: High-stress levels and a compromised immune system can increase the risk of developing facial palsy.

Recognizing Facial Palsy: Signs and Symptoms

Identifying the symptoms of facial palsy is crucial for prompt treatment. Let’s explore the signs to watch out for:

Symptoms of Facial Palsy

1. Sudden Weakness: The sudden onset of weakness or paralysis on one side of the face is a hallmark symptom.
2. Drooping of Facial Features: This may include drooping of the eyelid, corner of the mouth, or inability to close the eye.
3. Altered Taste Sensation: Changes in taste perception, especially on the front two-thirds of the tongue, can occur.
4. Increased Sensitivity to Sound: Some individuals experience heightened sensitivity to sounds in one ear.
5. Difficulty in Facial Expressions: Smiling, frowning, or making facial expressions on one side becomes challenging.

Diagnosis and Seeking Medical Help

When faced with these symptoms, seeking medical assistance is essential. A healthcare provider can perform various tests to diagnose facial palsy:

Diagnosis of Facial Palsy

1. Physical Examination: A thorough examination of facial muscle strength and reflexes is conducted.
2. Electromyography (EMG): EMG tests help assess the extent of nerve damage.
3. MRI or CT Scan: Imaging tests may be ordered to rule out other potential causes of facial weakness.

Treatment Options for Facial Palsy

The treatment approach for facial palsy is tailored to the individual’s needs and the severity of the condition. Here are some common treatment options:

Treatment Modalities

1. Medications: Antiviral drugs and corticosteroids are often prescribed to reduce inflammation and promote recovery.
2. Physical Therapy: Exercises and facial massage techniques can help strengthen facial muscles.
3. Eye Protection: To prevent dryness and protect the eye on the affected side, artificial tears and eye patches may be recommended.
4. Surgical Interventions: In severe cases, surgery may be necessary to improve facial function.

The Road to Recovery

Recovery from facial palsy varies from person to person. It’s essential to be patient and persistent during this journey.

Recovery Tips

1. Follow Medical Advice: Adhering to your healthcare provider’s recommendations is crucial for a successful recovery.
2. Facial Exercises: Regularly practicing facial exercises can help regain muscle strength and control.
3. Emotional Support: Seek emotional support from friends, family, or support groups to cope with the emotional challenges of facial palsy.

Ayurvedic Treatment for Facial Palsy

There is a description in Ayurveda called Ardita which can be correlated to facial palsy due to more similar symptoms. It is one among the 80 nanatmaka vataja vyadhi (80 different types of vata-originated diseases).

Acharya Vagbhata gives ‘Ekayama’ as the synonym to ‘Ardita’. Some Acharya Charaka opines it is a complication occurring due to suppression of sneezing and Vagbhata says it is a secondary disease due to improper management of Nasya karma (installation of medicine in the nostrils).

There is vitiated vata dosha localized in one half of the face. Acharya Charaka and Vagbhata mention the condition Ardita with or without the involvement of the body. The word ‘Ardita’ is derived from the root word “Ardana” which means pain, discomfort, or trouble.

Etiology and signs/symptoms

The etiology mentioned for Ardita is as follows:

• Uchchaivyaharata (excess shouting),
• Atihasana (excess laughing),
• Atijrumbhana (excess yawning),
• Atiprabhasanam (excess speaking),
• Uttrasavaktra (overexertion on the face),
• Kshavathu (excess sneezing),
• Shirasobharaharanam (carrying heavy weight on the head),
• Vishamadupaghaana (use of uneven surface pillow while sleeping),
• Kathina bhakshana (eating or chewing hard substances),
• Vishama shayasana (sleeping on uneven surfaces or beds).

The risk factors of Ardita are Garbhini (pregnant woman), sutika (woman in the postpartum stage), bala (children), vruddha (old aged people), ksheena (emaciated), asrik kshayayukta (anemia or in people who have blood loss).

The premonitory symptoms of Ardita are explained in detail by Acharya Sushrutha and those are – vayu urdhwa gamana (vitiated vata dosha moves in the upward direction), romaharsha (horripilations), tvacha supti (numbness of the skin), netra aavilata (vision and the eyes become like muddy), vepathu (tremors), toda (pricking type of pain in the affected area), hanu graha (lockjaw).

The symptoms of the condition Ardita are as follows:

• Vakrardha vakrata (distortion of the affected side of the face),
• Nasa-bhru-akshi-lalata-hanu vakrata (distortion of the nose-eyebrows-eyes-forehead-jaw),
• Greeva apavartanam (distortion of the neck),
• Greeva-chibuka-danta parshva vedana (pain in the sides of the neck, chin, and teeth),
• Vaktra nasika (deviated nose),
• Gandha-ajnana (loss of smell),
• Stabdha netra (eyes remain fixed),
• Vaksanga (impaired speech),
• Shravana badhyata (difficulty in hearing),
• Swarabheda (hoarseness of the voice),
• Dantachala (loosening of teeth),
• Shira chalaha (shaking of the head),
• Vakrabhojana (ingested food moves to one side of the mouth),
• Parshvataha nishthivana (drooling of saliva from the angle of the mouth),
• Kshavathu nigraha (suppression of sneezing),
• Urdhwa jatru ruja (pain in the neck),
• Moha (delusion), smriti nasha (loss of memory),
• Supti (numbness on the affected side)etc.

Types

There are three types of ardita explained in Ayurveda according to Bhavaprakasha, Yogaratnakara, Harita

1. Vataja ardita : symptoms are – lalasrava (excess salivation), vakgraha (obstruction in speech), hanugraha (lockjaw), vyatha (pain), kampa (tremors), aushtha shotha-shoola (pain and swelling in the lips)
2. Pittaja ardita – pittam aasya (yellowish discoloration of the face), trushna (excess thirst), jwara (fever), ushnata (feeling of heat)
3. Kaphaja ardita – shotha and stambha of ganda-manya-shiras (swelling and stiffness of cheeks-neck-head)

Treatment of facial palsy in Ayurveda

Ardita is said to be difficult to treat or duschikitsya according to many Ayurveda scholars due to the predominant vata dosha involved in it. Acharya Sushrutha opines that the condition becomes incurable when there is kshina avastha (emaciation), prsakta- avyakta bhashi (inarticulate speech), animishakshi (fixed eyes), and of the origin of three years old.

The general line of treatment for Ardita is based on the Vatavyadhi treatment, where the vata dosha is the only dosha involved in treatment with internal oleation therapy (snehana) by giving ghee, oil, muscle fat, or marrow can be given.

In the cases where the patients are emaciated Swedana (sudation therapy), Anuvasana basti (oil enema), Navana (medication installation in the nose), Murdha taila (anointing head with medicated oils), Akshi and Shrotra tarpana (filling oil in the eyes and ears), Upanaha (poultice), Tarpana aahara (oleation therapy with fats added to milk and milk pudding, meat soup, the meat of domestic and aquatic animals, and rice boiled with green gram should be given).

In the conditions where there is swelling Vamana (emesis) therapy and if there is a burning sensation and redness on the affected site, Siravyadha karma (venesection) can be administered.

Oral medications for facial paralysis are to be selected based on the pathogenesis and dosha involved in the disease.

Diet and lifestyle

Food items that mitigate the aggravated vata dosha like black gram, red variety of rice, milk, milk pudding, green gram, butter, meat, and meat soup. These can be taken along with ghee /oil /muscle fat/ marrow.

Oil massage, shiro basti (holding the medicated liquid in the equipment placed over the head), internal oleation, and medicine installation in the nostrils are some of the procedures that can be done at intervals of time for the improvement in the symptoms of facial palsy.

Conclusion

In conclusion, facial palsy, or Bell’s palsy, may seem perplexing at first, but with the right information and medical guidance, it can be managed effectively. Recognizing the symptoms, seeking timely medical help, and following the prescribed treatment plan are pivotal steps toward recovery.

Ardita is a disease primarily involving vata dosha affecting one side of the face with or without the involvement of the body. The clinical features of Ardita are more resembling that of facial palsy explained in modern science. The management is based on Vatavyadhi Chikitsa. Oleation therapy with oil enema, medicine installation in the nose, filling oil in the eyes and ears, food mixed with fats, and anointing the head with oil are some of the measures explained yet a physician has to decide the line of treatment depending on the condition. 

Now that you’re better informed about facial palsy, you can take proactive steps towards a healthier, more confident you.

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Frequently Asked Questions (FAQs)

1. Can facial palsy be permanent?

No, facial palsy is typically temporary, and many individuals experience significant improvement with time and appropriate treatment.

2. Are there any lifestyle changes that can help prevent facial palsy?

While facial palsy is often caused by viral infections or other factors beyond control, maintaining a healthy lifestyle and managing stress can contribute to overall well-being.

3. Is facial palsy contagious?

No, facial palsy itself is not contagious. It is a result of various underlying factors, including viral infections.

4. Can children get facial palsy?

Yes, children can develop facial palsy, although it is more common in adults.

5. How long does it take to recover from facial palsy?

Recovery times can vary, but many people see improvement within a few weeks to a few months with appropriate treatment and rehabilitation.

References

1. https://ijrap.net/admin/php/uploads/2173_pdf.pdf
2. https://ijrar.org/papers/IJRAR19L1696.pdf
3. https://jaims.in/jaims/article/view/2035
4. https://www.jetir.org/papers/JETIR2207091.pdf
5. https://ijapr.in/index.php/ijapr/article/view/651
6. https://www.ayurline.in/index.php/ayurline/article/download/604/864/2064