Suggest Treatment For Bell's Palsy

Posted on Wed, 29 Oct 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Thu, 30 Oct 2014 Answered on

Sat, 15 Nov 2014 Last reviewed on

Question : In August 2013 I was stricken with Bell's Palsy (right side of face) and continue to struggle with it. My face has pretty well returned to normal on the outside. I still am unable to produce a full smile as the muscle that controls the upper lip muscle has not come back yet. My biggest problem is dealing withh the internal healing around my righty eye and right check area. My eye continues to get skinty and tear up for no reason. Whenever I eat or drink I cannot hold my eye open and as a result cannot see the food on my plate when I look down. If drinking from a plastic bottle my right eye immediately closes and I am not able to keep it open when drinking. In addition, my right check feels like it is swelling and dead, the upper and lower right lips get very tight periodically, and I somtimes feel very disoriented and unable to focus due to the discomfort on the right side of my face (hard to concentrate and focus). If I pull on the right side of my face or grab and hold my right cheek the condition improves immediately. However, as soon as i release the pressure the symptoms return immediately. These symptoms are for the most part pain free, but are very difficult to deal with as i just do not feel normal and it is a constant nusience. None of the doctors i have been seeing can figure it out. I have had xrays, MRI's, MRA's of both head and neck, catscans, checked for autoammune disorders, and recently had surgery for a deviated syptum on the right nostril. Please help!

Answered by Dr. Het Ram Bishnoi (8 hours later)

Brief Answer:
After effect of Bell's palsy

Detailed Answer:
Hello XXXX
If the Bell's palsy has existed for some time and recovery of motor neuron is incomplete , a continuous diffuse contraction of facial muscles may appear.The palpebral fissures become narrow and nasolabial fold deepens .
Attempt to move group of facial muscles may result in contraction of all ( associated movements , typically as you mentioned in your query ,that if pull right side , grab & hold ,right cheek condition improve but discomfort returns if pressure release).
Facial spasms, initiated by movements of the face , may develop hemifacial spasm.
Anomalous regeneration ( AFTER Bell's palsy) of 7th nerve fibers may result in other troublesome phenomena , if fibers originally connected with orbicularis oculi ( as you mentioned that mouth muscles or lips not working properly as this is due to involvement of orbicularis oculi or mouth muscle ), closure of lids may cause a retraction of the mouth ( as in your case ) or the fibers if connected to lacrimal gland , anomalous TEARING occurs ( as you mentioned that eye get skinty and tears up with no reason , as this is due to lacrimal glands).
Hemifacial spasm consists of painless irregular involuntary contractions on one side of the face . Symptoms may develop as a SEQUELA of Bell's palsy.
Treatment :
Hemifacial spasm can be treated successfully with CARBAMAZEPINE or , if this drug fails , with BACLOFEN.
If still no relief then refractory cases require surgery ( decompression of facial nerve).
However in this answer there are certain medical terms but it was important so that you can understand better about your disease .
Hope this will help you.
Further any question I will reply in follow up.
So consult a neurologist and get a prescription as mentioned .
Good luck.

Above answer was peer-reviewed by : Dr. Yogesh D