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Ask Dr. Gott 7/11
Bell's palsy recovery slower than expected
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    DEAR DR. GOTT: I have been suffering with Bell's palsy for over one year. Although I have shown remarkable recovery, I have not returned to normal. I still can't whistle, nor do I have total control over the left side of my face.
    From this point, I am at my wits' end about getting back to normal. Is there anything I can do to improve my condition? Over the course of the last four months, I have not shown any more progress.
    DEAR READER: Bell's palsy is facial paralysis that results from damage or trauma to one of the two facial nerves. As a general rule, one side of the face is affected; however, both sides can be involved. Symptoms can come on suddenly without warning and reach their peak within 48 hours.
    Some cases are mild and don't require treatment, with symptoms subsiding within two weeks without treatment. Other cases result in a drooping eyelid or mouth corner, excessive tearing, facial paralysis, twitching, weakness, facial distortion and dry mouth. For severe cases, medication such as acyclovir, perhaps coupled with prednisone (a steroid), is sometimes used to reduce inflammation. Alternative therapy might include relaxation techniques, heat, biofeedback, acupuncture and vitamin/mineral therapy of B-6, B-12 or zinc.
    Surgery to relieve pressure on the affected nerve can be done, but the procedure is controversial and generally not recommended except in severe cases that don't heal.
    About 40,000 people develop Bell's palsy each year. Scientists believe a viral infection is most often the cause of the palsy, with herpes simplex (the common cold-sore virus), herpes zoster (the shingles virus) and viral meningitis bringing on the condition most often.
    While there is no specific testing, a primary-care physician can generally make a diagnosis based on a visual examination. If questions remain, an electromyograph (EMG) can confirm the presence of any nerve damage. X-rays, MRIs and CT scans can be ordered to eliminate other possible sources of pressure on the nerve.
    I don't know whether the cause of your palsy was ever identified and what medication you might have been on, but I am concerned your palsy has lasted more than a year. It may be time for you to speak frankly with your primary-care physician to get his or her view on the situation. Is your doctor satisfied with your progresss, or was a full recovery anticipated six months ago? If you are satisfied with your physician's performance, stick with the program. If not, perhaps it is time for a referral to a neurologist, or for you to get a second opinion on your own from another primary-care physician. I don't doubt your diagnosis, but another physician might have other views and could suggest more aggressive therapy.
    To give you related information, I am sending you a copy of my Health Report "Medical Specialists." Other readers who would like a copy should send a self-addressed, stamped, No. 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.
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