Bells Palsy treatment, a review of natural medicine treatment
December 2 2017 by Ray Sahelian, M.D.

Bell's palsy is a form of temporary facial paralysis resulting from damage or trauma to one of the two facial nerves. It 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.

Medical treatment
Bell palsy is an acute affliction of the facial nerve, resulting in sudden paralysis or weakness of the muscles on one side of the face. Testing patients with unilateral facial paralysis for Lyme disease is not routinely recommended. Patients with Lyme disease typically present with additional manifestations, such as arthritis, rash, or facial swelling. Steroids improve resolution of symptoms in patients with Bell palsy and remain the preferred treatment. Antiviral agents have a limited role, and may improve outcomes when combined with steroids in patients with severe symptoms. When facial paralysis is prolonged, surgery may be indicated to prevent ocular desiccation secondary to incomplete eyelid closure. Facial nerve decompression is rarely indicated or performed. Physical therapy modalities, including electrostimulation, exercise, and massage, appear to be neither beneficial nor harmful.

Nutritional and dietary supplement remedies
There's hardly any research published on natural ways to treat this condition.

Sixty patients with Bell's palsy were included in an open randomized trial. Patients were assigned into three treatment groups: steroid (group 1), methylcobalamin (group 2) and methylcobalamin + steroid (group 3). Comparison between the three groups was based on the number of days needed to attain full recovery, facial nerve scores, and improvement of concomitant symptoms. The time required for complete recovery of facial nerve function was significantly shorter in the methylcobalamin and methylcobalamin plus steroid groups than in the steroid group. The facial nerve score after 1-3 weeks of treatment was significantly more severe in the steroid group compared to the methylcobalamin and methylcobalamin plus steroid groups. The improvement of concomitant symptoms was better in the methylcobalamin treated groups than the group treated with steroid alone. Methylcobalamin treatment of Bell's palsy. Methods Find Exp Clin Pharmacology. 1995.

Email received in 2013
I have had Bell's Palsy twice in my life. The first time I was a young man, and it came and went in 2 weeks or less with no lingering effects. The second time, which was 3 years ago now I was not so lucky. I knew that after 3 weeks without any improvement whatsoever that I was going to be long term this time, particularly since the corticosteroids I took in the first 3 days had no effect. I decided to pursue a treatment plan which has had some success with others, which was acupuncture with electrical stimulation with all needles placed at specific locations on the affected side of my face. I chose to augment this treatment with Methycobalamin after I read an article which contained a lecture by a doctor who was involved in neurological research at the University of Alberta. His suggestion was to begin an escalating dose of Methylcobalamin until a max dose was reached and maintained as long as no side effects were experienced. I believe that max dose was 30,000 I.U. Without question I noticed a difference in that nerve activity (qualified by muscle twitching) certainly increased on the affected side of my face, and it seemed that recovery was indeed increasing. I must note here that my recovery, while still not complete was certainly not fast, and here three years later I still have perhaps only 85 % recovery, I suspect I will get no more.

Putting a washcloth soaked in warm water on your face several times a day may help relieve pain.

Role of acupuncture
Bell's palsy or idiopathic facial palsy is an acute facial paralysis due to inflammation of the facial nerve. Somestudies published in China have suggested acupuncture is beneficial for facial palsy, particularly when done in the active stage.

Complement Ther Med. 2017. Acupuncture and Kinesio Taping for the acute management of Bell's palsy: A case report. Bell's palsy is an idiopathic, acute peripheral palsy of the facial nerve that supplies the muscles of facial expression. Despite an expected 70% full recovery rate, up to 30% of patients are left with potentially disfiguring facial weakness, involuntary movements, or persistent lacrimation. The most frequently used treatment options are corticosteroids and antiviral drugs. However, accompanying clinical conditions, such as uncontrolled diabetes, hypertension, gastrointestinal disturbances, polypharmacy of geriatric patients, and significant sequelae ratios, indicate the need for safe and effective complementary therapies that would enhance the success of the conventional interventions. A 26-year-old female presented with numbness and earache on the left side of the face; these symptoms had been ongoing for 8-10h. Physical examination revealed peripheral facial paralysis of House-Brackmann grade III and corticosteroid-valacyclovir treatment was initiated. On the same day, Kinesio Taping was applied to the affected nerve and muscle area with the aim of primarily neurofacilitation and edema-pain relief. On the fifth day, acupuncture treatment was started and was continued for 3 consecutive days. A physical therapy program was administered for the subsequent 10days. At the 3-week follow-up examination, Bell's palsy was determined as grade I, and the treatment was stopped. Acupuncture and Kinesio Taping, in conjunction with physical therapy modalities, are safe and promising complementary therapies for the acute management of Bell's palsy. However, further large scale and randomized controlled studies are necessary to assess whether these complementary interventions have significant additive or synergistic effect for complete recovery of patients with Bell's palsy.

Symptoms and signs
Symptoms of Bell's palsy usually begin suddenly and reach their peak within 48 hours. Symptoms range in severity from mild weakness to total paralysis and may include twitching, weakness, or paralysis, drooping eyelid or corner of the mouth, drooling, dry eye or mouth, impairment of taste, and excessive tearing in the eye. Bell’s palsy often causes significant facial distortion.

Cause
Most scientists believe that a viral infection such as viral meningitis or the common cold sore virus -- herpes simplex-- causes the disorder when the facial nerve swells and becomes inflamed in reaction to the infection.

Medical treatment
The use of prednisolone should be considered in patients with severe BP.

Aspirin, ibuprofen (Advil, Motrin, others) or acetaminophen (Tylenol, others) may help ease your pain.

Med Sci Monit. 2014. The neurologist's dilemma: A comprehensive clinical review of Bell's palsy, with emphasis on current management trends. BP is currently considered the leading disorder affecting the facial nerve. The literature is replete with theories of its etiology, but the reactivation of herpes simplex virus isoform 1 (HSV-1) and/or herpes zoster virus (HZV) from the geniculate ganglia is now the most strongly suspected cause. Despite the advancements in neuroimaging techniques, the diagnosis of BP remains one of exclusion. In addition, most patients with BP recover spontaneously within 3 weeks. Corticosteroids are currently the drug of choice when medical therapy is needed. Antivirals, in contrast, are not superior to placebo according to most reliable studies. At the time of publication, there is no consensus as to the benefit of acupuncture or surgical decompression of the facial nerve.

New research
Plast Reconstr Surg Glob Open. 2017. Recovery from Bell Palsy after Transplantation of Peripheral Blood Mononuclear Cells and Platelet-Rich Plasma. Peripheral blood mononuclear cells (PBMCs) are multipotent, and plasma contains growth factors involving tissue regeneration. We hypothesized that transplantation of PBMC-plasma will promote the recovery of paralyzed facial muscles in Bell palsy. This case report describes the effects of PBMC-plasma transplantations in a 27-year-old female patient with right side Bell palsy. On the affected side of the face, the treatment resulted in both morphological and functional recovery including voluntary facial movements. These findings suggest that PBMC-plasma has the capacity of facial muscle regeneration and provides a promising treatment strategy for patients suffering from Bell palsy or other neuromuscular disorders.

Course and prognosis
The majority of patients experience minor damage to the myelin sheath, thus usually recovering spontaneously and with no particular treatment within a month to six months. However, others may, without adequate treatment, experience serious complications, starting from prolonged weakness of facial muscles, syncretism, hyperkinesias, contractions, even complete paralysis of facial muscles.

Questions and comments
I have had Bells Palsy for many years. Will Tahitian noni juice help cure my condition, or improve it? What about natural anti-inflammatory herbs such as turmeric, curcumin, boswellia, cat's claw? Also about serrapeptase.
   I have not seen research regarding the use of noni juice for Bell's palsy nor the other herbs and supplements such as serrapeptase.

Since 1999 I have been battling bilateral Bell's Palsy. Using many supplements, trying biofeedback, etc. I am a naturopath and I tried things in hope for some results. Stopped a progress of it, got it even much better from the original state, but no recovery. Cannot smile, eating is a major problem. Facial weakness combined with facial spasms are still there.