FACIAL PARALYSIS
Introduction
Facial paralysis can be a condition in itself or it could be a symptom of some other more serious problem with the nervous system of the person, especially the nerves that run to the facial region. The commonest known facial paralysis today is that caused due to the idiopathic condition known as Bell's Palsy which is known to affect about 0.1% of the population and is responsible for three-fourths of all facial paralysis conditions.
However there are several reasons due to which paralysis of the face can occur. This article tries to delve into the details of the causes, symptoms and Ayurvedic treatment options for facial paralysis.
Definition of Facial Paralysis (Ardita)
Facial paralysis is defined as the total loss of all voluntary movement on one or both sides of the face. Due to this, the person cannot move any muscle in the affected region.
Facial paralysis is differentiated from facial paresis. Paralysis refers to the complete loss of movements; while paresis is an incomplete form of paralysis in which the person does retain some voluntary movements in the affected region. In fact one of the first steps in the diagnosis of facial paralysis is to determine whether the condition is that of paralysis or of paresis.
Also it is necessary to determine whether the nerves in the forehead are involved in the facial paralysis or not. To determine this, the examiner would make the person lift his or her eyebrows and check to what extent they can be pushed up. This will help determine whether the lower or the upper motor neuron is involved.
Hence, diagnosis of the facial paralysis is important. The following is a generalized manner in which it is determined which nerve is responsible for the facial paralysis:-
| Symptom/Region Affected | Responsible Nerve or Organ |
| The entire face is paralyzed, including the motion of the eyebrows. | Facial Nerve |
| The mid face is paralyzed, but eyebrow can move normally. | Regions within the brain, where the Facial Nerve passes to |
In Sanskrit, facial paralysis is termed as ardita. It is a disease caused due to the vata dosha, which is the air element of the human body.
Causes of Facial Paralysis (Ardita)
There are a very large number of causes that can lead to facial paralysis. The following are the most prominent of them:-
(i) Bell's Palsy
Bell's Palsy is the single largest cause of facial paralysis – it causes about 75% of all facial paralysis cases. Bell's Palsy is an idiopathic condition (i.e. its cause is unknown) and hence it is very difficult to diagnose it directly. The diagnosis of Bell's Palsy is done by excluding all other factors that cause facial paralysis.
Modern research shows strong evidence that Bell's Palsy is caused due to the herpes virus, though this cannot be said with conviction.
(ii) Injury or Trauma
If a person has suffered an injury on the face which has affected the facial nerve, then there is a strong chance that the person may suffer from facial paralysis, at least on one side of the face. Such traumas could be caused by the fractures of the temporal bones of the face.
In most cases, the facial paralysis occurs immediately after the trauma. When this happens, the condition can be surgically corrected. However in some traumatic conditions, there is an aggravation of symptoms due to edema or inflammation, due to which the facial paralysis can occur later on.
(iii) Tumors
Cancers in the facial region are very strong contributing factors to facial paralysis. Tumors that arise in the facial region can exert pressure on the facial nerve which could lead to the paralysis.
(iv) Infections
Viral infections also lead to facial paralysis. The herpes zoster virus is considered responsible for the Herpes Zoster Oticus, which affects the cranial nerves.
Apart from these, Lyme disease and strokes are also responsible for facial paralysis.
Symptoms of Facial Paralysis (Ardita)
Though different types of facial paralysis have different symptoms, the commonly observed symptoms are mentioned below:-
- The person feels stiffness in the face and there is difficulty in moving the face. Normal activities like holding water in the mouth, closing the eyelids seem to be difficult and sometimes impossible.
- Numbness sets in with the paralysis. There is loss of sensation in the face.
- The face becomes expressionless and motionless.
- Eating and drinking become difficult.
Complications of Facial Paralysis (Ardita)
Facial paralysis may or may not be complicated depending on its causes. The facial paralysis caused due to Bell's Palsy is a temporary condition, which can be treated in a few months. Similarly, the facial paralysis due to infection is cured when the infection is treated.
However, facial paralysis due to tumors is a very serious condition. This is due to the tumor itself and not the facial paralysis. In such cases, the paralysis could spread to the hands, chest and even the legs.
Transmission of Facial Paralysis (Ardita)
Most cases of facial paralysis are internal disorders that cannot be transmitted from one person to another. But the facial paralysis that is caused due to the herpes zoster virus is infectious.
Prevention and Basic Care during Facial Paralysis (Ardita)
It is necessary to take some basic care and preventive measures to see that the facial paralysis does not exacerbate much. The following precautions must be taken:-
- The face must not be exposed to drastic weather conditions, especially of the cold and the rain.
- In winter special care needs to be taken as the nerves can become number. The face (as well as the whole body) must be kept properly draped with a shawl in the daytime and a blanket in the nighttime.
- Extreme care must be taken while sleeping. In most people with facial paralysis, the eyes cannot be closed. This can introduce foreign bodies into the eyes and cause infections. Hence the eyes must be cleaned regularly.
- It is necessary to sleep in the night. Tiredness and sleepiness in the daytime aggravates the vata of a person.
Diet for People with Facial Paralysis (Ardita)
Since facial paralysis or ardita is a condition caused due to the aggravation of the vata dosha, it is necessary to take a diet that balances the vata. The following dietary guidelines must be followed:-
- All cold foods must be avoided. This includes ice-creams and cold drinks, as well as cold fruits and vegetables such as oranges, green bananas, papayas, watermelons and cucumbers.
- Curds and other sour foods must be avoided.
- Fermented foods can aggravate the vata and hence must be avoided.
- Even pulses and their preparations such as dals are harmful to a person with ardita.
- Yellow pumpkin and colocasia also must be avoided as they can be harmful to the person.
- The diet must consist of wheat rather than rice.
- Green leafy vegetables are best in conditions of facial paralysis.
- Cow's milk is preferable to buffalo milk.
- Alcohol and smoking must be avoided at all costs.
Apart from all these guidelines, it must be remembered to keep the diet simple and easily digestible. If not, then there are chances that constipation may occur. in constipated conditions, the Ayurvedic medicines for facial paralysis will not show their effects.
Ayurvedic Treatment of Facial Paralysis (Ardita)
There are some herbs which can be effectively used to reduce the conditions of facial paralysis. The following is a list of these herbs with their actions on the human body.
| Ayurvedic Name of the Herb | Biological Name of the Herb | Common English Name of the Herb | Action on the Human Body |
| Beejband, Jungli Methi | Sida cordifolia | Country Mallow | The country mallow contains an alkaloid which was initially confused with the very beneficial ephedrine. The herb is used traditionally in India for treatment of facial paralysis due to its nervine properties. |
| Kali mari | Piper nigrum | Black pepper | Black pepper is used in a water gargle. It is supposed to rectify paralysis of the tongue. |
| Kudzu | Pueraria montana | Kudzu | Kudzu tablets help to reduce the tension in the facial muscles that are not yet affected by the Bell's Palsy. Hence they can prevent the further spread of the disease. |
| Lavanga | Syzygium aromaticum | Cloves | Just five to ten drops of clove oil in a quarter cup of water taken thrice a day helps to reduce the facial paralysis brought on by Bell's Palsy. |
| Mulethi | Glycyrrhiza glabra | Licorice | Mulethi is an effective herb for stopping the progress of partial paralysis into complete paralysis. It can stop the automatic flowing of tears from the eyes in people with facial paralysis. In order to avail of better benefits of licorice, this herb is taken in conjunction with foods rich in potassium such as bananas. |
The herbs mentioned above have been expertly mixed into preparations. These preparations contain just the right proportions of herbs so as not to produce major side effects. The following are some herbs that are effective in the treatment of Facial Paralysis:-
| Type of Preparation | Name of Preparation |
| Asava/Arishta | Dashamula Arishta |
| Bhasma/Kashaya | Ashtavarga Kashaya, Dhanvantaram Rasadi Kashaya |
| Choorna | Rasna Choorna |
| Ghrita | Trivrita Ghrita, Rasnaadi Ghrita |
| Lehya | Rasnaadi Lehya, Sukumara Lehya |
| Rasa | Mahavata Vidhwasa, Brihat Vata Chintamani |
| Vati | Vatagajankusha, Shalaki |
Some age old practices have been used in Ayurveda to bring relief in people with facial paralysis problems. The following are some of the treatment methods:-
· Hot fomentation is very effective, and the effect becomes more pronounced when some salt is used for fomenting. Be careful to test the fomenting material before applying on the face of the patient, because the numb portion of the face will have no sensitivity to the heat. Fomentation should be given more on the area below the ear, as this is the region from where the facial nerve passes out.
· Maharana taila is a very powerful herbal oil that can be massaged on the afflicted region. The oil should be only just tolerably warm. Be careful as it can get hot very fast. After the massage the patient should remain indoors for about an hour of the massage.
In addition, the following medications can be given:-
| Ayurvedic Preparation | Mode of taking | Action on the human body |
| Vatagajankusha | Two pills to be taken thrice a day with honey | This vati soothes the nerves and removes the numbness. |
| Dashamula Arishta | Six teaspoonfuls twice a day after meals, mixed in an equal amount of water | The arishta preparation of Dashamula (literally meaning 'ten roots'). It has several beneficial on the human body such as:- Soothes the nervous system Tones up the nerves Reduces inflammation |
If the person has constipation problems, then castor oil can be given to the patient as a purgative. This will help the medicines to become more effective.
It must be borne in mind that while taking any Ayurvedic preparation, the doctor must be consulted first. Most of the herbs do not have any side-effects (and are indeed a regular part of the diet), but some people may be allergic to certain herbs and may show adverse reactions.
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