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Vitamins and Supplements Rooted in Science - Life Extension
Bell’s Recommended Products
ACETYL L CARNITINE 500 MG 100 CA…
METHYLCOBALAMIN 5MG 60 SUBLINGLO…
Bell’spalsy is a paralysis of the facial muscle, usually occurring on only one side of the face. Approximately one person in every 4000 contracts the disease in any given year. It is more common among diabetics with high blood pressure and among pregnant women in the last third of their pregnancy.
The facial nerve passes through a narrow channel of bone in the face, so when the nerve swells due to inflammation, the result may be nerve compression and degeneration. The resulting lack of nerve function mainly prevents facial movement, but salivation, tear production, and facial sensation may also be reduced.
Recovery from Bell’s palsy typically begins 3 weeks after onset of symptoms for 85% of patients, who fully recover within 6 months. About 5% experience permanent deformity. Younger patients have a better recovery rate than older ones. About 10% of patients will experience a recurrence of the disease at some time after recovery.
Traditionally, Bell’s palsy was defined as a facial paralysis of unknown cause, but that definition has become controversial. It is now widely believed that as many as 80% of the cases are due to herpes simplex virus, with the remainder largely due to infectious agents such as influenza virus, HIV, Lyme disease, herpes zoster, and tuberculosis. Facial paralysis can also be due to cancer or facial trauma (frequently seen in infants delivered by forceps).
There are two herpes simplex viruses which are similar in genetic composition, designated HSV1 (oral) and HSV2 (genital). In both diseases, the virus enters the body though a mucous membrane or skin abrasion and is transported to nerve cell bodies in nerve ganglia where it "hides." Various stress conditions can cause the disease to manifest as cold sores (HSV1) or genital sores (HSV2). These stresses include menstruation, dental extraction, coldness, or exposure to other infectious agents, particularly upper respiratory tract infection—and these same stresses are associated with Bell’s palsy. The evidence has become strong that Bell’s palsy is usually the only manifestation of a herpes reactivation. In the great majority of cases, HSV1 is the causative agent, but there is a well-documented case of a 24-year-old man who developed paralysis on both sides of his face within 2 weeks of performing oral sex on a female partner who had active genital herpes blisters.
Therapy
In addition to the risk of permanent nerve damage, Bell’s palsy patients can experience serious eye damage. Use of artificial tears, ophthalmic ointments, and protective goggles may be required under the guidance of a physician. In some cases, physical therapy is required to strengthen facial muscles.
In most clinical trials, the proven therapies for speeding recovery and reducing the risk of permanent damage have been combinations of the anti-inflammatory drug prednisone (steroid) with the herpes-suppressive drug Acyclovir (Billue 1997; Roob et al. 1999; Schmutzhard 2001). In one clinical trial (not including Acyclovir), intramuscular injections of 500 mcg of the methylcobalamin form of vitamin B12 3 times weekly resulted in faster recovery than treatment with the steroid.
In another study by Jalaludin (1995), 60 people with Bell’s palsy were divided into three groups. The first group was given standard steroid therapy. The second was given methylcobalamin plus steroid. The third was given methylcobalamin alone. It took 2-9 weeks for the drug group to recover. The groups given methylcobalamin recovered much quicker, some within days. The group given methylcobalamin alone recovered the quickest.
The value of methylcobalamin for Bell’s palsy is supported by the fact that methylcobalamin is also used in therapy for diabetic neuropathy and a number of other neurological diseases (Anon. 1998). Methylcobalamin is known to promote synthesis of DNA and myelin proteins, facilitate regeneration of crushed nerves in animal experiments, and protect cultured neurons from glutamate toxicity. Methylcobalamin can be taken as sublingual tablets in the dose of 40 mg a day or by intramuscular injection (500 mcg 3 times a week) administered by a physician.
Another clinical trial has shown that 1 gram 3 times daily of acetyl-L-carnitine in combination with steroid resulted in earlier functional improvement in Bell’s palsy over steroid alone. Although this experiment has not yet been repeated by other researchers, acetyl-L-carnitine has also been shown to promote nerve regeneration in animal experiments, to improve nerve function in diabetic neuropathy, and to be of proven value in a number of other neurological diseases.
SUMMARY
Eye protection as directed by a physician.
Steroid and/or antiviral (such as Acyclovir) or other appropriate treatment if another infectious organism has been demonstrated.
Physical therapy if advised by a physician.
Methylcobalamin, 500 mcg 3 times weekly by intramuscular injection by a physician. Alternatively, the Life Extension Foundation provides 5 mg sublingual lozenges which bypass digestion. Suggested dose is 40-80 mg daily until symptoms subside.
Acetyl-L-carnitine, 1 gram 3 times daily.
