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Suggest Treatment For Headache When Diagnosed With Bell's Palsy
Question: Late July 2016 had left sided bells palsy that was very mild. Had ct of brain without contrast (negative) and MRI with contrast (negative) with dx due to viral infection. About same time had right eye flashes. Been to several eye and retinal doctors. They attribute to ocular migraines.
Early September 2016 had right sided Bell's palsy. It appeared to have resulted and it too was very mild. No known cause. Did have strong right tmj pain. Still have uneven smile and droop in right corner of lips.
Mid October 2016 awoke to pulsating in ear and still have it. ENT said will order Mri if not resolved by mid December. No hearing loss per testing. 2 small left side posterior cervical nodes are palpable and me right side posterior cervical. ENT said nothing to worry about, so did PCP.
late November 2016 had CBC with 11,200 on abc count but all other items were in middle of ranges. No diff was ordered. PCP felt no issues.
no fevers or chills since mid July except one random couple hour one in mid September.
no weight loss
some headaches recently but attribute that to poor sleep from sick kids
blood pressure is around 125/75 with 90 for pulse throughout these months
a stiff neck at times. Chiropractor says muscles are tight.
should I be concerned about cancer, brain tumors, infection in brain blood tumors in brain or sarcadodis in brain ?
Early September 2016 had right sided Bell's palsy. It appeared to have resulted and it too was very mild. No known cause. Did have strong right tmj pain. Still have uneven smile and droop in right corner of lips.
Mid October 2016 awoke to pulsating in ear and still have it. ENT said will order Mri if not resolved by mid December. No hearing loss per testing. 2 small left side posterior cervical nodes are palpable and me right side posterior cervical. ENT said nothing to worry about, so did PCP.
late November 2016 had CBC with 11,200 on abc count but all other items were in middle of ranges. No diff was ordered. PCP felt no issues.
no fevers or chills since mid July except one random couple hour one in mid September.
no weight loss
some headaches recently but attribute that to poor sleep from sick kids
blood pressure is around 125/75 with 90 for pulse throughout these months
a stiff neck at times. Chiropractor says muscles are tight.
should I be concerned about cancer, brain tumors, infection in brain blood tumors in brain or sarcadodis in brain ?
Brief Answer:
There is no cause for worry.
Detailed Answer:
Hi,
Thank you for your query.
1. Alternating facial palsy is rare but can happen without any underlying disease process. Your scans and tests are normal, hence there is no cause for worry about tumors.
2. Currently, it should be treated with steroids and physiotherapy and tests should be done to check for infections (including a dental source) since you have raised blood counts and jaw pain. Rule out problems with wisdom teeth.
3. If this recurs, there is a rare condition called Melkersson Rosenthal Syndrome that should be ruled out. This syndrome can be related with Crohn's Disease and Sarcoidosis (such as eye symptoms and lymph nodes). However, the chances of diagnosing these conditions is rare as you do not have many of the symptoms.
I hope that I have answered your query. If you have any further questions, I will be available to answer them.
Regards.
There is no cause for worry.
Detailed Answer:
Hi,
Thank you for your query.
1. Alternating facial palsy is rare but can happen without any underlying disease process. Your scans and tests are normal, hence there is no cause for worry about tumors.
2. Currently, it should be treated with steroids and physiotherapy and tests should be done to check for infections (including a dental source) since you have raised blood counts and jaw pain. Rule out problems with wisdom teeth.
3. If this recurs, there is a rare condition called Melkersson Rosenthal Syndrome that should be ruled out. This syndrome can be related with Crohn's Disease and Sarcoidosis (such as eye symptoms and lymph nodes). However, the chances of diagnosing these conditions is rare as you do not have many of the symptoms.
I hope that I have answered your query. If you have any further questions, I will be available to answer them.
Regards.
Above answer was peer-reviewed by :
Dr. Remy Koshy
I will try for a follow up MRI.
More I read online the more I get worried about cause of Bell's palsy separated my 40 days.
Both cases were mild but recent right side still has not resolved completely.
Will steroids and physiotherapy still help this late in the process?
Going to local ent next week. Any specific tests to order?
More I read online the more I get worried about cause of Bell's palsy separated my 40 days.
Both cases were mild but recent right side still has not resolved completely.
Will steroids and physiotherapy still help this late in the process?
Going to local ent next week. Any specific tests to order?
Brief Answer:
Details as discussed below:
Detailed Answer:
Hi,
Thank you for writing back.
1. Physiotherapy will definitely help. I routinely anti-virals and steroids (1mg/kg/day, tapered) in the treatment.
2. The follow up MRI is important. Limited CT images should be done to look for any dehiscence of the bony canal of the facial nerve (which would make it more prone to infections). Repeat your hearing and acoustic reflex tests. Nerve function tests are usually done in the first month. The other disorders are non-specific and have no specific tests. It is best to consult a General Medicine (MD) for this.
I hope that I have answered your query. If you have any further questions, I will be available to answer them.
Regards.
Details as discussed below:
Detailed Answer:
Hi,
Thank you for writing back.
1. Physiotherapy will definitely help. I routinely anti-virals and steroids (1mg/kg/day, tapered) in the treatment.
2. The follow up MRI is important. Limited CT images should be done to look for any dehiscence of the bony canal of the facial nerve (which would make it more prone to infections). Repeat your hearing and acoustic reflex tests. Nerve function tests are usually done in the first month. The other disorders are non-specific and have no specific tests. It is best to consult a General Medicine (MD) for this.
I hope that I have answered your query. If you have any further questions, I will be available to answer them.
Regards.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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