Bell’s palsy involves dysfunction of a nerve that controls facial muscles, resulting in weakness or paralysis of one side, or more rarely both sides, of the face. Most people with Bell’s palsy partially recover without treatment within two to three weeks, achieving full recovery within three or four months.
Integrative interventions including methylcobalamin, acetyl-L-carnitine, and omega-3 fatty acids can help improve recovery and protect nerves from inflammatory damage.
Causes and Risk Factors for Bell’s Palsy
- Herpes simplex virus type 1 (HSV-1) and herpes zoster virus (chickenpox)
- Commonly affects people ages 15‒50
- Diabetes, pregnancy, and lowered immunity increase risk
Signs and Symptoms of Bell’s Palsy
- One-sided facial paralysis that occurs over a few hours to a few days. This includes a droop to the mouth on the affected side and an inability to frown, close the eye, or produce tears.
- This can cause the cornea to become dried out which could lead to long-term visual impairment.
- In most cases, symptoms resolve completely. However, people who do not have some recovery within 21 days have a greater risk of lasting facial muscle weakness.
Note: It is important that a medical professional differentiates Bell’s palsy from stroke. Medical attention should be sought when symptoms of facial paralysis begin to appear irrespective of whether they are thought to be caused by Bell's palsy or stroke.
Diagnosis of Bell’s Palsy
- Bell’s palsy is a clinical diagnosis based on symptoms as well as history and physical exam findings.
- Two grading scales are used to quantify the severity of Bell’s palsy: the House-Brackmann Facial Nerve Grading System and the Sunnybrook Facial Grading System.
Conventional Treatment for Bell’s Palsy
- Corticosteroids are used to reduce inflammation. Artificial tears and ophthalmic ointments can be used to prevent damage to the cornea.
- Surgery to relieve compression on the facial nerve may be necessary in some cases.
Novel and Emerging Strategies for Bell’s Palsy
- Infusion therapy consists of corticosteroids mixed in an infusion solution containing dextran and pentoxifylline, which increase blood flow to the facial nerve.
- Studies have found that laser therapy and hyperbaric oxygen therapy can be helpful for recovery from Bell’s palsy.
Dietary and Lifestyle Interventions
- A low-arginine/high-lysine diet may help slow the growth of the herpes simplex virus and shorten the duration of Bell’s palsy. Foods low in arginine and high in lysine include dairy products, fish, and chicken.
- Acupuncture may relieve symptoms of Bell’s palsy, and biofeedback can treat involuntary muscle movements that sometimes occur after incomplete recovery from Bell’s palsy.
- Methylcobalamin: Methylcobalamin plus a steroid helped patients recover much faster than a steroid alone in a study of subjects who had Bell’s palsy longer than two weeks.
- Acetyl-L-carnitine: A study of subjects with facial palsy found that supplementing with acetyl-L-carnitine along with methylprednisolone reduced a measure of paralysis by half, whereas it remained the same with methylprednisolone alone.
- Omega-3 fatty acids: Omega-3 fatty acids like eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) support the creation of different anti-inflammatory compounds that can protect nerves from damage.
- Niacin: In a series of 74 cases treated with 100‒250 mg of niacin, 73 cases resulted in good facial nerve response within 2‒4 weeks.
- Anti-viral interventions: Natural agents shown to combat viral infection, including licorice, zinc, lysine, and reishi mushrooms, may be of some benefit for those affected by Bell’s palsy.