The Mad Teddy Bear's blog: "Horoscope Lie and Life sucks"

Viral and bacterial infections, as well as autoimmune disorders, appear to be emerging as the most frequent common thread in the etiology of Bells palsy. HERPES SIMPLEX 1 As far back as 1970, Herpes Simplex 1 was suggested as a cause of Bell's palsy (Dr. Kedar Adour). Some Bells palsy must still be designated as idiopathic, but a 1995 study (Dr. Shingo Murakami and others) points compellingly to the herpes simplex virus (HSV-1) as the most frequent cause of Bell's palsy, possibly accounting for at least 60 - 70% of cases. Additional research since this study was published has been reinforcing the conclusion. Exposure to HSV-1 is common; a vast majority of the population has been exposed to it. Most people are exposed during childhood. Kissing between relatives is the most frequent source of exposure, but it may be possible that the virus is also spread while sharing towels, utensils, etc. The active virus is commonly associated with cold sores, but the virus often runs its course without causing any blisters - blisters actually appear only 15% of the time. This results in a large population of HSV-1 carriers who do not know they've been exposed to the virus. HSV-1 is infectious for a short time following the incubation period. It then enters a dormant state, residing on nerve tissue. There are several triggers that can cause the dormant virus to reactivate. As this site is about Bell's Palsy, rather than herpes, we will not address issues concerning herpes outbreaks where the reactivated virus sheds to the skin. When the latent virus reactivates at the facial nerve the immune system begins to produce antibodies, causing an inflammation. This is a normal function, and is part of the process that eliminates harmful foreign bodies such as viruses and bacteria so that we can recover from illness and injury. If the location of the inflammation is within the fallopian canal (described above) there is no room for the swelling to expand. The nerve itself becomes inflamed, or the inflammation within the canal exerts pressure on the nerve. The result is that the nerve is compressed inside its bony tube. Compression of the nerve is the injury that stops transmission of signals to muscles. Unable to receive signals to contract and relax, the muscles become temporarily weakened or paralyzed. The triggers for reactivation of the virus prior to the onset of Bell's palsy have not been proven conclusively. Impaired immunity, whether temporary (stress, lack of sleep, minor illness, physical trauma, upper respiratory infection, etc.) or long-term (autoimmune syndromes, chronic disease, etc.) are strongly targeted as the most likely triggers. OTHER VIRAL LINKS There has been research implicating other viruses, including cytomegalovirus, Epstein-Barr, rubella and mumps, in the etiology of Bell's palsy. As with the herpes virus, potential triggers appear to be related to conditions that affect the immune system. The internal process that would cause the nerve to become compressed and result in Bells palsy is currently thought to be the same as described above for the Herpes virus. RAMSEY HUNT SYNDROME Ramsey Hunt syndrome is similar to Bell's palsy. Unlike Bells palsy, the virus that causes Ramsey-Hunt syndrome has been conclusively identified. It is varicella zoster virus (VZV), which is the virus that causes chicken pox, and is a strain of the Herpes virus. Like HSV-1, it remains in the body, residing on nerve tissue in a dormant state on nerve ganglia after the initial infectious stage has passed. VZV typically remains dormant for decades. The incidence of Ramsey Hunt syndrome increases significantly after age 50. Younger patients with Ramsey-Hunt syndrome are often advised to be tested for autoimmune deficiencies. Ramsey-Hunt syndrome results in symptoms that are in many respects identical to Bell's palsy. The symptoms are so alike that a diagnosis of Ramsey Hunt syndrome can easily be missed. When the VSV virus is reactivated the resulting eruptions (blisters) are known as shingles. The first symptom is usually severe pain. There may also be a fever, headache, and localized tenderness. Blisters typically begin to emerge 1.5 to 3 days after the onset of these symptoms, although they may emerge with no prior symptoms. Symptoms of Ramsey Hunt Syndrome In addition to the "classic" symptoms of Bells palsy, Ramsey Hunt syndrome is associated with some additional symptoms that help differentiate it. Knowledge of these symptoms is key to an early diagnosis, and should be brought to a doctor's attention during the first visit, or when any of these symptoms become apparent. 1. Pain: Bell's palsy patients may complain of pain (often in or behind the ear) which can be acute. However, it will tend to fade within a week or two. The pain associated with Ramsey Hunt syndrome is often more severe, and more likely to be felt inside the ear. It may start before muscle weakness is apparent, and may last for weeks or months - sometimes longer. Medications such as Neurontin can ease the post-herpatic pain of Ramsey Hunt syndrome. 2. Vertigo: Dizziness is occasionally reported by Bells palsy patients, but is often associated with Ramsey Hunt syndrome. It can be more severe, and longer lasting. 3. Hearing loss: Unlike Bell's palsy, Ramsey Hunt syndrome can also affect the auditory nerve (CN-VIII), resulting in hearing deficit. This should not occur with Bells palsy, and is an important clue to the diagnosing physician. In some cases hearing loss will continue after facial muscle function returns. 4. Blisters: The primary symptom that makes a diagnosis of Ramsey Hunt syndrome likely is the appearance of blisters (known as shingles, or herpes zoster) in the ear. The blisters can appear prior to, concurrent to, or after the onset of facial paralysis. They can be expected to last 2 - 5 weeks, and can be quite painful. The pain can continue after the blisters have disappeared. Blisters are often the only clearly visible symptom that identifies Ramsay Hunt. Unfortunately, they may not be evident during the diagnostic examination. They can be present, but too deep within the ear to be visible. Or they can be too small to be seen. In some cases they may not appear until a week or more after the onset of muscle weakness. At times they do not appear in the ear at all, but may be present in the mouth or throat. It is also possible for the virus to reactivate without blisters at all. 5. Swollen and tender lymph nodes near the affected area. While Bell's palsy is not contagious, shingles blisters are infectious. Contact with an open blister by someone who has never had chickenpox can result in transmission of the virus. The result will be chickenpox, not shingles or facial paralysis. ** If you've been diagnosed with Bell's palsy, but later see blisters that may be shingles, its important that you notify your health care professional. ** HIV / AIDS HIV can cause facial paralysis and increases the chance of developing Ramsey Hunt syndrome, as well as Bell's palsy. In the early stage of HIV, paralysis can be directly due to the viral infection. In later stages paralysis is more likely to be associated with the opportunistic infections or tumors associated with severe immune deficiency. Herpes zoster has been confirmed to be associated with suppressed immune systems. BACTERIAL TRIGGERS... Lyme disease can cause facial paralysis and the same symptoms as Bells palsy. Bacteria enter the body through the skin at the site of the tick bite. Typical early symptoms of Lyme disease are a red ring around the site of the bite and flu-like symptoms. Unfortunately these symptoms do not always appear. The early symptoms will pass, but administration of an antibiotic as early as possible is important to avoid serious problems later. Without an antibiotic the bacteria can spread throughout the body, causing arthritis, heart disease, and nervous system disorders such as facial paralysis. Otitis Media - Bacteria from some acute or chronic middle ear infections can invade the canal around the nerve through small portals. As with viruses, the presence of bacteria can evoke an inflammatory response, and compress the nerve. BILATERAL ... Bell's palsy and Ramsey Hunt syndrome can be bilateral, but it's extremely rare. Mononucleosis, the flu, Guillain - Barre Syndrome, leukemia, lyme disease, sarcoidosis and Heerdfort's Syndrome are among the potential triggers of bilateral palsy. MELKERSSON-ROSENTHAL SYNDROME Melkersson-Rosenthal syndrome can result in unilateral or bilateral palsy. The palsy will tend to be recurrent, to such an extent that it's sometimes described as intermittant or bilateral. Recurrences don't follow any pattern - each recurrence can be on the same side, alternating side, or bilateral. Diagnosis of this syndrome can easily be missed, as the obvious symptoms may look like Bells palsy. However, unlike Melkersson-Rosenthal syndrome Bell's palsy recurrences tend to be separated by wide timespans. OTHER CAUSES ... Facial and surgical wounds, trauma due to a blunt force, temporal bone fractures, brain stem injuries, acoustic neuromas, cysts and tumors can result in facial palsy. Diabetes and thyroid conditions are also associated with facial palsy. Lupus, Sjogrens syndrome and congenital defects can, infrequently, cause facial paralysis. C&P'd from http://www.bellspalsy.ws/cause.htm Adam The Mad Teddy Bear of the South!!!

WHAT IS BELL'S PALSY? Bells palsy is a condition that causes the facial muscles to weaken or become paralyzed. It's caused by trauma to the 7th cranial nerve, and is not permanent. WHY IS IT CALLED BELL'S PALSY? The condition is named for Sir Charles Bell, a Scottish surgeon who studied the nerve and its innervation of the facial muscles 200 years ago. HOW COMMON IS BELL'S PALSY? Bells palsy is not as uncommon as is generally believed. Worldwide statistics set the frequency at approximately .02% of the population (with geographical variations). In human terms this is 1 of every 5000 people, and 40,000 Americans every year. IS BELL'S PALSY ALWAYS ON THE SAME SIDE? The percentage of left or right side cases is approximately equal, and remains equal for recurrences. IS THERE ANY DIFFERENCE BECAUSE OF GENDER OR RACE? The incidence of Bells palsy in males and females, as well as in the various races is also approximately equal. The chances of the condition being mild or severe, and the rate of recovery is also equal. WHAT CONDITIONS CAN INCREASE THE CHANCE OF HAVING BELL'S PALSY? Older people are more likely to be afflicted, but children are not immune to it. Children tend to recover well. Diabetics are more than 4 times more likely to develop Bells palsy than the general population. The last trimester of pregnancy is considered to be a time of increased risk for Bell's palsy. Conditions that compromise the immune system such as HIV or sarcoidosis increase the odds of facial paralysis occurring and recurring. CAN BELL'S PALSY AFFECT BOTH SIDES OF THE FACE? It is possible to have bilateral Bells palsy, but it's rare, accounting for less than 1% of cases. With bilateral facial palsy, it's important to rule out all other possible diagnoses with thorough diagnostic tests. CAN BELL'S PALSY AFFECT OTHER PARTS OF THE BODY? Bells palsy should not cause any other part of the body to become paralyzed, weak or numb. If any other areas are affected Bell's palsy is not the cause of the symptoms, and further testing must be done. HOW DO THE SYMPTOMS OF BELL'S PALSY PROGRESS? Very quickly. Most people either wake up to find they have Bells palsy, or have symptoms such as a dry eye or tingling around their lips that progress to classic Bell's palsy during that same day. Occasionally symptoms may take a few days to be recognizable as Bells palsy. The degree of paralysis should peak within several days of onset - never in longer than 2 weeks (3 weeks maximum for Ramsey Hunt syndrome). A warning sign may be neck pain, or pain in or behind the ear prior to palsy, but it is not usually recognized in first-time cases. IS BELL'S PALSY CONTAGIOUS? No, it is not contagious. People with Bells palsy can return to work and resume normal activity as soon as they feel up to it. WHAT ABOUT RECOVERY FROM BELL'S PALSY? Approximately 50% of Bells palsy patients will have essentially complete recoveries in a short time. Another 35% will have good recoveries in less than a year. Regardless of the trigger, Bell's palsy is best described as an event - trauma to the nerve. As with any other injury, healing follows. The quality and duration of recovery is dependent on the severity of the initial injury. If the nerve has suffered nothing more than a mild trauma, recovery can be very fast, taking several days to several weeks. An "average" recovery is likely to take between a few weeks and a few months. The nerve regenerates at a rate of approximately 1-2 millimeters per day, and can continue to regenerate for 18 months, probably even longer. Improvement of appearance can continue beyond that time frame. IS MUSCLE ATROPHY A CONCERN? Not as a rule. It takes longer for the muscles to start to atrophy than it takes for most people to fully recover. IS BELL'S PALSY LIKELY TO HAPPEN AGAIN? The possibility of recurrence had been thought to be as high as 10 - 20%. These figures have been lowered as more has been learned about conditions that are now diagnosed as other types of facial palsies. Estimates of the rate of recurrence still vary widely, from around 4 - 14%. Most recent reports hover at 5 - 9%. The average timespan between recurrences is 10 years. C&P'd from http://www.bellspalsy.ws/ look up more info if you wish You think you know but you had no idea! Adam The Mad Teddy Bear of the South!!!

few good links for T.I.A.'s if your interested in what iw as talking about in my frist log look here: has FAQ and a few other usefull info: http://www.ninds.nih.gov/disorders/tia/tia.htm you may also want to look at: http://www.stroke-tia.com/ another good one: http://www.apsfa.org/tiasymptoms.htm http://www.wrongdiagnosis.com/artic/ninds_transient_ischemic_attack_tia_information_page_ninds.htm If you didnt know you do know! Adam The Mad Teddy Bear of the South!!!

Today's Horoscope Gemini - There's such a thing as news being too good. Oh, wait -- no there isn't! You receive a piece of information that pretty much makes your day. Give it a moment to sink in and you'll see it's just good enough to be true. LIES all LIES!!!! What i havent told anyone just my family and now those who wish to read this is on friday night (saturday morning) i went to the ER b/c i keep haveing a sharp pain go down the left side of my body..it had happened af ew days ago (wensday) and i shoulda caught on that it might have been a T.I.A.(mini strokes if you didn't know) b/c i got really really tired after it happened and i was told that i looked said all day adn the next day....well come friday i finaly realized what they where talking about my face on the left side was dropy and i realized i coudlnt control it very well basicly not at all well fearing the worse i called and work up my dad to ask him about it b/c my mom has T.I.A.s alot b/c she's had 7+ strokes and always told me if i get a sharp pain and suddenly get really really sleepy(which i did) to not fight it as it can make the T.I.A. worse..but i didnt even thinkt hat at the time and just keep going (this happened at work so couldnt really stop) anyway so i go to the ER they rush me back tot he room wheni put the reason for being there gott here at 2am was in a room by 2:05 and was talking to the doctor by 2:07....oh did i also mention i have been extraemly disorented and not realizing it..thats also a side effect (i'll get to side effect of what in a sec) anyway so i get Xrays done and a CT...takes all of like an hr and half to get results...so i get the results.... haveinga mussle spasm in my left shoulder causeing the shooting pain but on top of that i have Bell's Palsy which is a nerve thing that they dont knwo what cause it...i also found out from my dad in talking to him earlier that night that it also runs in the family... well they put me on anti-virals b/c they say that some think its a viral infection causeing swelling of a nerve in the face so now im on 3 diff meds..one makes me super dissy and the other two...well they just f**k with me in differnt ways....i can still work and funcstion but i'm really slow and what not and feel like i cant get motivated...but the doctor warned me that might happen...which is ok..anyway i think thats enough rambling for one night. thank you for takeing the time to read this if you did i have alot of info on bell's palsy but still it sucks to no extent... P.S. had to write this 4 times as i was told it had alot of wrong letters and stuff having one of my roommates proof read is a good idea lol anyway if you have any questions leave me a message, email what ever i'm on yahoo if you wanna reach me there if i'm not on then i'll answer asap.....i try to go back to work today so if i cant do it i ahve to call the doctor and tell them whats up...oh and i have to go see a speicalist on wensday i think so ya...... Adam Hooks.....The Mad Teddy Bear of the South!!!!