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Spring is right around the corner, although it may not seem like it because of the cold temperatures.
One day it is too warm for a jacket in the evening, and the very next day a freezing cold morning breeze makes you dig out the winter coats again.
The large fluctuations in the day-to-day temperatures mean that our overall immune system may not function as well as it should.
Also, during this time of the year, there are a higher number of patients suffering from facial nerve palsy, which makes the face appear asymmetrical.
According to a report by the Health Insurance Review & Assessment Service that analyzed records over the past five years, the number of patients who visited an Oriental hospital or clinic increased from 61,000 in 2010 to 120,000 in 2014 —
a whopping 95 percent uptick.
Facial nerve palsies can be categorized into two classes: the central nervous
type and a peripheral nerve type.
As all muscles are controlled by the opposite hemispheres of the brain, facial muscles are no exception to this rule.
When the nerve passage that connects the brain to the facial muscles causes facial nerve palsy, it is classified as central facial palsy. If the facial nerves outside the
brain cause facial nerve palsy, it is then classified as peripheral.
The most common cause for acute central facial palsy is a stroke (from a cerebral infarction or hemorrhage) in which case the facial palsy is accompanied with other symptoms such as unilateral paralysis of the upper and lower limbs, lowered
nerve response, speech impediments, ataxia and loss of vision.
In general, however, most facial nerve palsy cases are peripheral types commonly known as Bell's palsy.
While it is said to occur when a patient is exposed to a cold external environment under severe stress and physical strain, the exact causes have not been identified.
In recent years, viral infection has been linked as the likely culprit.
The second most common type of peripheral facial palsy is from the Ramsay-Hunt Syndrome, where the virus from shingles (herpes zoster) becomes reactivated to
cause the palsy. It is also more likely that the patient may suffer from longer-term
effects.
Apart from the facial palsy, the patient may also suffer from pain in the ear, bullous dermal lesions, dizziness and loss of hearing.
The most important step in treating facial nerve palsy is to initially diagnose whether it is central nerve palsy which can be accompanied by severe neurological effects, or peripheral facial palsy such as Bell's palsy.
With central types, while the lower half of the face appears paralyzed, the patient can still frown and blink their eyes.
With peripheral types, frowning and blinking are impossible.
With central facial palsy, the symptoms are most severe on the day of occurrence, but with peripheral types, they tend to become most severe after three days.
Central types are also very likely to accompany other symptoms such as unilateral paralysis of upper and lower limbs, speech impediments and loss of mobility.
If you suspect a central nerve facial palsy, it is recommended that you seek immediate professional help by visiting a hospital to undergo proper tests such as CT and MRI scans to get the appropriate treatment.
Oriental medicine considers that peripheral facial nerve palsies are caused by wind-cold, qi deficiency and blood deficiency.
Wind-cold is the most frequently occurring cause.
Facial nerve palsy caused by sleeping while exposed to the cold wind, or with
fan or air-conditioner on, or driving in an open convertible car are all such cases. Qi and blood deficiency are caused by overwork that causes chronic gastrointestinal disorders or other diseases that damage qi and blood.
Generally speaking, about 60 to 70 percent of peripheral facial nerve palsy patients recover on their own.
With mild symptoms, it may last between seven to 10 days from the initial occurrence before showing signs of recovery, and a full recovery that does not show any symptoms takes about six weeks.
However, with more severe symptoms, a full recovery may take months and some even won't reach that state.
Such a difference is dependent upon where the initial inflammation occurred on the nerves, and prognosis can be made after monitoring the initial symptoms.
With milder cases, patients display sensory issues such as a decline in motor skills and an increase in tear secretions on the affected side; and often they lso complain of a loss of taste and heightened sensitivity to sounds.
However, if the symptoms are accompanied by lack of lachrymal gland activity and disorders in hearing and balance, the prognosis can be bad. Therefore, it is crucial to implement appropriate treatment along with proper rest and monitoring of daily
activities from the initial occurrence.
In Oriental medicine, treatments include herbal medicine to mitigate the symptoms during the initial acute phase and to boost the body's natural recuperative powers during the recovery phase, and acupuncture to promote circulation of qi and
blood to the affected areas.
Patient should avoid stress and take plenty of rest while being mindful not to allow their face to come into contact with cold. Massaging the affected muscles whose movements are limited can help.
Pronouncing the vowels can also stimulate the facial muscles.
If the eyelids cannot be completely shut, the cornea can dry out and become susceptible to damage, so wearing a protective eye patch can be beneficial.
Often, with Bell's palsy, the actual facial paralytic symptom is preceded by a pain behind the ear. If you feel such symptoms, you can visit your local Oriental clinic to seek treatment.
The writer practices Oriental medicine at the UN Oriental Medical Clinic in Hannam- dong, Seoul.
