Bell's Palsy

Bell's palsy is a form of temporary facial paralysis resulting from damage or trauma to the facial nerves. The facial nerve-also called the 7th cranial nerve-is travels through a narrow, bony canal (called the Fallopian canal) in the skull, beneath the ear, to the muscles on each side of the face. Each facial nerve directs the muscles on one side of the face, including those that control eye blinking and closing, and facial expressions such as smiling and frowning. Additionally, the facial nerve carries nerve impulses to the lacrimal or tear glands, the saliva glands, and the muscles of a small bone in the middle of the ear called the stapes. The facial nerve also transmits taste sensations from the tongue. When Bell's palsy occurs, the function of the facial nerve is disrupted, causing an interruption in the messages the brain sends to the facial muscles. This interruption results in facial weakness or paralysis. The disorder, which is not related to stroke, is the most common cause of facial paralysis. Generally, Bell's palsy affects only one of the paired facial nerves and one side of the face, however, in rare cases, it can affect both sides. Symptoms Because the facial nerve has so many functions and is so complex, damage to the nerve or a disruption in its function can lead to many problems. Symptoms of Bell's palsy can vary from person to person and range in severity from mild weakness to total paralysis. These symptoms may include Twitching, Weakness or paralysis on one or rarely both sides of the face.

Other symptoms may include drooping of the eyelid and corner of the mouth, drooling, dryness of the eye or mouth, impairment of taste, and excessive tearing in one eye. In some cases, symptoms like pain or discomfort around the jaw and behind the ear, ringing in one or both ears, headache, loss of taste, 1

hypersensitivity to sound on the affected side, impaired speech, dizziness, and Difficulty eating or drinking.

Most often these symptoms, which usually begin suddenly and reach their peak within 48 hours, lead to significant facial distortion.

Causes
Bell's palsy occurs when the nerve that controls the facial muscles is swollen, inflamed, or compressed, resulting in facial weakness or paralysis. Exactly what causes this damage, however, is unknown. The disorder has also been associated with influenza or a flu-like illness, headaches, chronic middle ear infection, high blood pressure, diabetes, sarcoidosis, tumors, Lyme disease, and trauma such as skull fracture or facial injury.
Diagnosis

A diagnosis of Bell's palsy is made based on clinical presentation -- including a distorted facial appearance and the inability to move muscles on the affected side of the face -- and by ruling out other possible causes of facial paralysis. There is no specific laboratory test to confirm diagnosis of the disorder. Generally, a physician will examine the individual for upper and lower facial weakness. In most cases this weakness is limited to one side of the face or occasionally isolated to the forehead, eyelid, or mouth. A magnetic resonance imaging (MRI) or computed tomography (CT) scan can eliminate other structural causes of pressure on the facial nerve. Ayurvedic view, Ardita is a vata vyadhi, its genesis is from pakwashaya, as it is the primary seat of Vata (Bhela). Always the Vata diseases are manifested because of two reasons the former being Dhatukshayam and the latter is Margavarana. Ardita is one of the 80 nanatmaja vata vyadhi Ardita afflicts the face and other closely associated organs i.e. Upangas of Shiras. In Ardita vata, there is affliction of both jnanendriyas and Karmendriyas. Shirovasthi, one among the Moordhni taila chikitsa, it is an important treatment modality explained by Sushruta as the first line of treatment for Ardita.

The Vata vitiated by its own causes afflicts the half of the mouth (and other regions of the head) Vagbhata uses the term Ekayama for Arditha Causative factors Sandharana suppression of natural urges Diwa svapna sleeping during day time Ratri jagarana awakening at night Mada Intoxication Ucchairbhasya (speaking loudly) Ati maithuna excessive indulgence in sex Asatmya gandha inhalation of undesirable smell Ati seta ambu sevana excessive intake of cold water Abhigata to siras injury to head Dushta ama vitiation by ama Bashpa nigraha suppression of tears Manastapa anxiety and other mental stresses

Due to the above causes, the doshas get aggravated resulting in the vitiation of rakta dhatu in the head and leads to morbidity. Purvarupa Romaharsha (horripilation) Vepanam (trembling) Avila netrata (eye being not clear) Vayuroordhwa (upward movement of Vata) Twachi swapa (loss of sensation of skin) Toda (pain) Manya sthamba (stiffness of the neck) Hanugraha (stiffness of the jaw)

Rupa Distortion of the affected side of the face (the mouth angle is drawn over to the opposite side) If the patient tries to laugh, the mouth angle is drawn to the normal side There is also pulling of neck towards normal side Tremors or shaking of the head and also teeth Rigid and wrinkles of the eye, closing of the affected eye is difficult

Distortion of the nose Difficulty in speech and hoarseness Loss of hearing and smell sensation and pain in the ear also Spitting is affected to one side only Sneeze gets suppressed Severe pain in the neck, chin, teeth on the affected side Loss of memory etc.

Samprapti The vata vitiated by the earlier stated causative factors, settles in the regions of head, nose, chin, forehead and eyes and produces the disease called Ardita. The symptom of vaksanga indicates that the vitiated vata affects the tongue also. Vagbhata has indicated the affliction of the ear on the affected side. As per Charaka the vitiated vata while settling in the above stated regions in the head accounts for the soshana of the rakta dhatu resulting in ardita. Here, the soshana may be understood as a reduced supply of rakta to the particular region affecting the normal physiological functions (jeevana kriya). Treatment principle, Vata vrddhi in Kapha sthanam Kapha vata shamanam Avaranagnam Ushna virya drugs are selected Kayam Cam Avagandha cam 10 grams with milk at night after food (B.Prakasha) Kapikachu choornam 10 grams with milk at night after food Narasimha choornam 10 grams with milk at night after food Svalparasona pindam 3 grams with eranda kashayam in the morning Danadanayandi kayam 60 ml twice daily before food. (Sahasra yogam) Mabala tmaguptdi kayam 60 ml twice daily before food. (Chakradatta) Rasondi kayam 60 ml twice daily before food. (S.Y) Ashtavargam 60 ml twice daily before food. Bhadradarvadi 60 ml twice daily before food.

Gulika Tailam Mahamasha tailam 10 ml with milk at night after food Karpasasthyadi tailam 10 ml with milk at night after food Ksheerabala 10 ml with milk at night after food Ashtadashanga masha tailam 10 ml with milk at night after food Rasondi tablet 2 0 -2 after food.

Rasa ouadi Ekgavra ras 2 tablets twice daily after food Bruhatvata chintamani ras 125 mg twice daily after food (Bhaishajya Ratnavali) Vata gajankusha ras 125 mg twice daily after food

Ariam Thalam Rsndi choornam with Nimbmrutha eraddi tailam Balriam 15 ml twice daily after food. (S.Y/Bhaishajya Ratnavali) Avagandhriam 15 ml twice daily after food. (Bhaishajya Ratnavali Apasmaram) Devadrvariam 15 ml twice daily after food. (Sharangadhara Samhita)

Abhyagam for face Kavalam Krpsasydi tailam Pacasneham Prabajanam oil Mahamasha tailam Vishnu taila Vata kesari tailam

 Nasyam

Krpsastiydi tailam Sahacharadi

Mashabaladi tailam 2 drops in each nostrils (Chakradatta) Krpsastydi tailam 2 drops in each nostrils Mahamasha tailam 2 drops in each nostril Krabala tailam - 2 drops in each nostrils Chukku tailam 2 drops in each nostril (Siddha)

Kra dhmam Varudi kayam

Siddha medicines Mavilangam kudineer 60 ml twice daily before food Poornachandrodayam 1 tablet twice daily after food Tippili choornam 2 grams twice daily with honey after food Amukkara choornam 10 grams with milk at night after food Chandamarutham 50 mg with honey twice daily (3 days in a week) Narasimha lehyam 10 grams bd after food