Bell's palsy is a disease of the facial nerve (cranial nerve VII) that produces unilateral or bilateral facial weakness. Onset is rapid. In 80% to 90% of patients, it subsides spontaneously and recovery in complete in 1 to 8 weeks. If recovery is partial, contractures may develop on the paralyzed side of the face. Bell's palsy may recur on the same or opposite side of the face. Although Bell's palsy affects all age groups, it occurs most often in people under age 60. Recovery may be slower in the elderly.
Causes : infection, Hemorrhage, Tumor, Meningitis, Local trauma.
Pathophysiology : Bell's palsy reflects an inflammatory reaction around the seventh cranial nerve, usually at the internal auditory meatus where the nerve leaves bony tussue. The characteristic unilateral of bilateral facial weakness results from the lack of appropriate neural stimulation to the muscle by the motor fibers of the facial nerve.
Signs and symptoms
- Distorted facial appearance and inability to raise the eyebrow, close the eyelid, smile, show the teeth, or puff the cheek.
- Unilateral facial weakness, occasionally with aching pain around the angle of the jaw or behind the ear
- Drooping mouth on the affected side (causing the patient to drool saliva from the corner of his mouth)
- Distorted taste perception over the affected anterior portion of the tongue
- Ringing in the ear
Radial nerve injury (Radial Nerve Palsy)
Injury to the radial nerve has a variety of possible causes. These include:
- fracturing your humerus, a bone in the upper arm
- sleeping with your upper arm in an awkward position
- pressure from leaning your arm over the back of a chair
- using crutches improperly
- falling on or receiving a blow to your arm
- long-term constriction of your wrist
The most common causes of radial nerve injury are breaking your arm, overusing your arm, and sports and work accidents. Depending on the level of injury, you may experience a complete laceration of the radial nerve. This occurs when the nerve is severed. It can cause symptoms that are similar to more minor injuries. A nerve laceration usually requires surgical repair.
Certain actions, when repeated often enough, can lead to radial nerve damage. Movements that involve both grasping and swinging movements, such as swinging a hammer, can lead to nerve damage over time. As the radial nerve moves back and forth over the bones of your wrist and forearm, there’s potential for the nerve to become trapped, pinched, or strained from these activities.
Lead poisoning can also lead to long-term nerve damage. Over time, the lead toxin can cause damage to the nervous system as a whole.
Certain health conditions that affect your whole body may damage one nerve. Kidney disease and diabetes may cause inflammation, fluid retention, and other symptoms that can, in turn, lead to nerve compression. This could affect the radial nerve or other nerves in your body.
Symptoms of an injury to the radial nerve
A radial nerve injury usually causes symptoms in the back of your hand, near your thumb, and in your index and middle fingers.
Symptoms may include a sharp or burning pain, as well as unusual sensations in your thumb and fingers. It’s common to experience numbness, tingling, and trouble straightening your arm. You may also find that you can’t extend or straighten your wrist and fingers. This is called “wrist drop” or “finger drop,” and it doesn’t occur in all cases.
Testing for and diagnosing a radial nerve injury
If you think you’ve injured your radial nerve, your doctor will start by asking you about your symptoms and when they began. This may help pinpoint what caused the injury.
Your doctor will also do a physical exam. They will look at your affected arm, hand, and wrist, and compare it to your healthy arm, hand, and wrist. They may ask you to extend and rotate your arm to see if the injury affects your range of motion. Your doctor will also ask you to extend your wrist and fingers, checking for any weakness or loss of muscle tone.
Your doctor may order tests to rule out other causes of your symptoms. For example, you may have blood tests to check your blood sugar and vitamin levels, as well as your kidney and thyroid function. These tests check for signs of other conditions associated with nerve damage, such as diabetes, vitamin deficiencies, or diseases of the kidney and liver. A CT scan or MRI can also look for diseases within your head, neck, or shoulders that may result in pressure on your radial nerve.
Your doctor may also consider electromyography (EMG) and nerve conduction tests. An EMG measures the electrical activity in your muscle. A nerve conduction test measures the speed at which impulses travel along your nerves. These tests can help determine if you are experiencing a problem in your nerve or in your muscle. They may also show whether the radial nerve is damaged.
In very rare cases, your doctor may request a nerve biopsy. This involves taking a small sample of the nerve and examining it to determine what is causing the damage.
The goal of treatment for radial nerve injury is to relieve symptoms while maintaining movement of your wrist and hand. The best treatment depends on the underlying cause. In some cases, symptoms go away slowly on their own without intervention. Your doctor may prescribe medication or other therapies to help manage your symptoms.
There are several different first-line treatment options available. These include:
- analgesic or anti-inflammatory medications
- antiseizure medications or tricyclic antidepressants (prescribed to treat pain)
- steroid injections
- anesthetic creams or patches
- braces or splints
- physical therapy to help build and maintain muscle strength
Some people choose transcutaneous electrical nerve stimulation (TENS) to treat nerve damage. This therapy involves placing several adhesive electrodes on the skin near the affected area. The electrodes deliver a gentle electric current at varying speeds.
Physical therapy to build and maintain muscle strength can help to heal and improve nerve function. Massage treatment is another option. Massage can break up scar tissue and make the radial nerve more responsive.
Analgesic or anti-inflammatory medication can help relieve the pain of a radial nerve injury. It may also help the injury heal faster. A single cortisone shot in the affected area can relieve pain. Anesthetic creams or patches can also be used to relieve pain, while still allowing movement.
It’s also common to use a brace or splint to immobilize the nerve. This might not sound like the most convenient option, but it may prevent you from reinjuring the nerve while it’s healing.
Less traditional treatment methods, such as acupuncture and chiropractic adjustments, are also an option. Keep in mind that evidence about whether some of these treatments work is mixed.
Most people with a radial nerve injury will recover within three months of starting treatment if the nerve is not torn or lacerated. But some cases ultimately require surgery. If your radial nerve is entrapped, surgery can relieve pressure on the nerve. If there is a mass, such as a benign tumor, on your radial nerve, you may need surgery to remove it.
The goal of surgery is to repair any damage to the nerve. Occasionally, when it is thought that the nerve will not heal, tendon transfers can be performed to restore function to the extremity. After surgery, you will need to wear a brace or splint to allow the injury or tendon transfer to heal. Your doctor will refer you to a physical therapist for rehabilitation to restore range of motion and strength.
How can I prevent radial nerve injury ?
You can prevent most radial nerve injuries if you avoid putting prolonged pressure on your upper arm. Avoid behaviors that can lead to nerve damage, such as repetitive motions or remaining in cramped positions while sitting or sleeping. If you work in an occupation that requires repetitive motions, take steps to protect yourself by taking breaks and switching between tasks that require different movements.
Recovery time and outlook
The long-term prognosis for a radial nerve injury varies greatly depending on the cause and severity of the injury. In most cases, a full recovery is possible. First-line treatment methods will generally heal most radial nerve injuries within 12 weeks.
If your nerve damage is the result of an underlying medical condition, such as diabetes or alcoholism, talk to your doctor about how to manage your symptoms.
People who are younger when the injury occurs and people who have additional nerve damage injuries tend to recover the most quickly. If surgery is needed, a full recovery can take from six to eight months.
Most people can feel the warning signs of a migraine coming on, and these symptoms may include tunnel vision, blurred vision, and eye pain. If you suspect a migraine, it is best to treat it as soon as possible. The symptoms of a migraine may differ from person to person but can include: Sensitivity to Light, Nausea, Throbbing Pain in One or Both Temples, Loss of Appetite.
Migraines are caused by abnormal brain activity triggered by an array of outside stimuli, including: Strong Odors or Perfumes, Certain Foods (baked goods, fruits, onions, fermented or pickled foods, etc.), Caffeine Withdrawal or Overuse, Hormonal Changes, Stress.
Headaches can be characterized as a throbbing sensation in the head or upper neck. Headaches occur due to pain signals traveling between the brain, blood vessels, and surrounding nerves.
Depending on the intensity and location of the pain, a headache can be classified between several different types, including : Migraines, Tension Headaches, Cluster Headaches, Neuralgia's
Headaches develop for numerous reasons. Headaches may also develop due to a head injury or trauma. Other common causes of headaches may include : Eyestrain, Poor Posture, Alcohol Use, Stress, Irregular Sleeping Pattern, Depression, Skipped Meals, Environmental Stimuli (changing weather, noise, tobacco smoke, perfume, and strong odors)
Multiple sclerosis (MS) is an inflammatory disease that affects the nerve cells of the brain and spinal cord. MS is found more commonly in women than in men, and though MS can occur at any age, the condition generally develops between the ages of 20 and 40.
A myelin sheath is a protective covering surrounding nerve cells. When these are damaged, nerve signals slow down or stop altogether, causing multiple sclerosis. It is unknown what causes the myelin sheath to deteriorate or become damaged, but it may be linked to genetics, certain viruses, or environmental factors.
Because MS can affect the nerve cells in any part of the brain or spinal cord, symptoms can affect many parts of the body. Patients suffering from MS may have any of the following symptoms: Visual problems, Slurred speech
Difficulty swallowing, Difficulty controlling muscle movements, Bladder and bowel difficulties
Numbness, tingling, or chronic pain, Fatigue
Those suffering from MS endure attacks lasting anywhere from a couple of days to several months. These episodes vary in length and severity. Following an attack is a period of reduced or no symptoms called a remission. The disease often returns, or relapses, however, and the disease may continue to worsen overtime.
Epilepsy is a neurological disorder that causes people to suffer from repeated mild to severe seizures due to electrical disturbances in the brain. Seizures can affect people at any age, but seizures mainly begin between ages 5 and 20.
Epilepsy is usually caused by a medical condition or brain injury, such as: Stroke, Brain Tumor, Traumatic Brain Injury, Infection, Dementia, Some Medications
Some people show signs of an oncoming seizure called an aura. These symptoms can include a tingling sensation, emotional changes, or smelling an odor that isn’t present.
Depending on the area of the brain affected, symptoms vary but may include: Violent Shaking, Staring into Space, Loss of Consciousness, Muscle Twitches or Stiffening
Some seizures last anywhere from several seconds to several minutes. Sometimes, the person remains conscious throughout the seizure, and other times, the person is unconscious during a seizure. It all depends on the person and the part of the brain affected.
Radiculopathy occurs when a nerve or nerves do not work properly, generally due to a problem in or near the nerve root. Often, symptoms occur not just at the location of the problem, but radiate to the part of the body served by that nerve.
This condition may have symptoms such as: Pain, Numbness, Weakness, Difficulty controlling affected muscles.
There are many types of Radiculopathy depending on the location of the nerve or nerves affected (e.g., in the lumbar, cervical, or thoracic spine).
Common causes of Radiculopathy include: Lack of blood flow, Pinched nerve, Inflammation, Excessive pressure from tendons or cartilage
Peripheral neuropathy is generally a result of nerve damage that causes numbness in the extremities (hands and feet). While one of the most common causes for nerve damage like this is diabetes, the condition can also be a result of: Infections, Exposure to toxins, Metabolic issues, Traumatic injuries
Peripheral neuropathy can occur in sensory nerves, motor nerves, or autonomic nerves, and most often starts in the nerves that reach to the toes. Symptoms depend on the affected nerves, but look out for the following: Burning
Gradual onset of numbness and tingling that can spread, Sensitivity to even the lightest of touches
Muscle weakness, Sharp, electric-like pain
Compressive mononeuropathy is a form of nerve compression that affects only one nerve, though it can occur to several nerves at once. Also known as entrapment neuropathy, this medical condition is a result of direct pressure on the nerve.
Possible Causes : A tumor, ganglion cyst, or a haematoma putting pressure on a nerve, Prolonged or repeated external force, Carpal tunnel syndrome, Weight gain and related illnesses such as hypothyroidism or diabetes
The symptoms of this condition are very much like nerve damage, which causes tingling, pain, numbness, and muscle weakness.
Dr.Kim's Herbs That clear Heat
SHI GAO and ZHI MU
Both substances clear Full Heat from the Qi level. SHI GAO is extremely cold in nature. It clears
Heat and Fire, particularly from the Lung and Stomach, and relieves restlessness. ZHI MU not only clears Heat and Fire but also nourishes Yin and promotes Body fluids. When combined, their action of clearing Heat from the Qi level is potentiated and they are indicated for : a) pathogenic Heat at the Oi level with symptoms of high fever, restlessness, thirst and profuse sweating b) cough and wheeze due to Full Heat in the Lungs c) toothache, haematemesis and epistiaxis due to Stomach Heat and Fire d) consumption of Body Fluids due to Full heat in the Lung and Stomach with symptoms of thirst, a desire to drink large quantities and loss of body weight.
SHI CAO, XI XIN, and BAI ZI
Shi Gao clears Stomach Heat and Fire. Xi Xin and Bai Zhi pungent and scattering in nature and relieve pain. The three substances in combination relieve pain due to Heat or Fire in the Stomach.They are indicated for toothache and headache due to Stomach Heat and Fire.
SHI GAO and SHENG MA
SHI GAO clears Stomach Fire. Sheng Ma clears Fire and Fire Poison. In combination they are indicated for painful and swollen gums and mouth ulcers due to Stomach Fire.
ZHI MU and BEI MU
Both herbs clear Lung Heat; Bei Mu also moistens dryness, resolves Phlegm and stops cough. In combination they are indicated for cough due to Lung Heat or Yin Deficiency with Empty Heat.
ZHI MU and HUANG BAI
Zhi Mu nourishes Yin and clears Fire while Huang Bai clears Empty Fire. In combination thery are indicated for spermatorrhoea and tidal fever due to Kidney Yin Deficiency with Empty Fire. With the the addition of Cortex Cinnamomi, this combination nourishes the Kidneys, stimulates the transformation of Water and promotes diuresis and is thus indicated for urinary dysfunction and oedema.
HUANG LIAN and HUANG QIN
Both herbs clear Heat, Fire, Fire Poison and Damp-Heat. Huang Lian works on the Upper Burner while Huang Qin works on the Middle Burner. They are often used in combination to treat retention of Heat and Fire in th Upper and Middle Burner, Retention of Damp-Heat in the intestines and retention of Fire Poison.
HUANG LIAN and MU XIANG
Huang Lian clears Heat, dries Dampness and stops dysentery while Mu Xiang regulates Qi, relieve pain and stops dysentery. In combination the action of clearing Heat from the intestines and stopping dysentery is potentiated and they and indicated for dysentery and abdominal pain due to retention Damp- Heat in the intestines.
HUANG LIAN and ROU GUI
Huang Lian Clears Heart Fire while Rou Gui warms Kidney Yang and conducts Ming Men Fire to its source. In combination they harmonize the Heart and Kidneys and indicated for insomnia due to disharmony between Heart and Kidneys.
HUANG LIAN and WU ZHU YU
Huang Lian is bitter and cold in nature; it clears Stomach Heat and stops vomiting. Wu ZHU YU is pungent and hot in nature; it enters the Liver Channel and conducts Rebellious Qi downward to stop vomiting. This combination is indicated for vomiting due to Stomach Heat and for epigastic pain and acid regurgitation due to disharmony between the Liver and Stomach.
HUANG QIN and BAI SHAO
Huang Qin clears Heat from intestines to stop diarrhea and dysentery while Bai Shao harmonizes the Blood and relaxes spasm. In combination they are indicated for abdominal pain and dysentery, especially with blood in the stool.
HUANG QIN and BAI ZHU
Huang Qin clears Heat and prevents miscarriage while Bai Zhu tonifies Qi, invigorates the Spleen and prevents miscarriage. In combination their action of preventing miscarriage is potentiated and they are thus indicated for threatened abortion.
HUANG BAI and ZHI ZI
Both herbs clears Damp-Heat and relieve jaundice. Huang Bai strongly clears Heat and dries Dampness while Zhi Zi drains Dampness and relieves urinary disturbance. In combination they are indicated for jaundice due to retention of Damp-Heat and for urinary disturbance with turbid urine due to Damp-Heat in the Lower Burner.
LONG DAN CAO, ZHI ZI and SHENG DI
Long Dan Cao and Zhi Zi clear Liver Fire. Sheng Di not only clears Heat but also nourishes Yin, thus preventing the first two herbs from damaging the Yin. This combination is indicated for Live Fire with symptoms of headache, red eyes, hypochondriac pain and jaundice and for Damp-Heat in the Lower Burner with symptoms of leucorrhoea and urinary disturbance with turbid urine.
DAN PI and ZHI ZI
Both of these herbs clear Liver Fire and cool Blood. This combination is thus indicated for Liver Qi Stagnation turning to Fire, or retention of Heat in the Liver Channel, with symptoms of hypochondriac pain, a bitter taste in the mouth, red eyes and headache, and for Heat in the Blood with symptoms of haematemesis and epistaxis.
XIA KU CAO and JU HUA
Both herbs clear Liver Heat, pacify the liver and improve vision. This combination is thus indicated for Liver Fire with symptoms of headache and eye disease, or Liver Yang Rising with symptoms of headache, dizziness and vertigo.
XIA KU CAO, XUAN SHEN, BEI MU, HAI ZAO, and KUN BU
Xia Ku Cao clears Liver Fire and disperses masses. Xuan Shen nourishes Yin and clears Fire and Poison. Bei Mu, Hai Zao, and Kun Bu resolve Phlegm and soften hard masses. The combination of there herbs is indicated for tuberculosis of the lymph nodes, goiter and tumours.
JIN YIN HUA and LIAN QIAO
Both herbs clear Heat and Fire Poison and this action is potentiated when they are used in combination. They are indicated for Heat and Fire Poison at the Defensive(Wei) and Qi Levels and for carbuncle, boils and ulcers.
DA QING YE or BAN LAN GEN and LONG DAN CAO
Da Qing Ye and Ban Lan Gen clear Heat and Fire Poison and are antiviral. Long Dan Cao clears Heat and Fire and stops convulsion. This combination is indicated for febrile diseases with Fire Poison, headache, convulsion and spasm due to high fever.
ZHI HU DI DING and PU GONG YING
Both clear Heat and Fire Poison and are thus indicated for sores and ulcers due to Fire Poison and for various infections.
HONG TENG and BAI JIANG CAI, and DA HUANG and DAN PI
These combination clear Heat and Poison. They are indicated for acute appendicitis and pelvic inflammation.
BAI TOU WENG, QIN PI and HUANG LIAN
This combination clears Heat and Fire Poison from the intestines, cools Blood and stops dysentery. It is indicated for dysentery with blood in the stool due to Fire Poison.
QING DAI and Ge Fen
Qing Dai clears Liver Fire and cools Blood. Ge Fen clears Phlegm Heat. In combination they clear Lung Heat and Liver Fire and cool Blood to stop bleeding. This combination is indicated for cough and haemoptysis due to invasion of the Lung by Liver Fire.
XI JIAO and SHENG DI
This combination clears Heat and cools Blood and is thus indicated for febrile disease at the Blood level and for haematemesis and epistaxis due to Heat in the Blood. Its action is further strengthened by the addition of Cortex Moutan Radicis and Radix Paeoniae Rubra.
SHENG MA and XUAN SHEN
This combination clears Heat, cool Blood, nourishes Yin and promotes Body Fluids. It is thus indicated for febrile disease at the Nutritive(Ying) and Blood levels and for constipation due to Liver and Kidney Yin Deficiency.
QING HAO and BIE JIA
This combination nourishes Yin and clears Heat and is thus indicated for tidal fever and night sweats due to Yin Deficiency with Empty Heat.
QING HAO and HUANG QIN
This combination clears Heat and harmonizes Shao Yang and is indicated for alternating fever and chills, severe fever and mild chills, or fever without chills.
YIN CHAI HU and DI GU PI
This combination clears Empty Heat and is thus indicated for Yin Deficiency with Empty Heat and tidal fever.
QIN JIAO and BIE JIA
Both herbs clear Empty Heat and this action is potentiated when the two are used in combination. In addition, Qin Jiao eliminates Wind-Damp, and BIE JIA nourishes Yin. This combination is indicated for Yin or Blood Deficiency with Empty Heat, tidal fever and painful joints due to Wind and Dampness.