Bell’s palsy brings fear of stroke

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DEAR DR. DONOHUE: Will you please give me some information about Bell’s palsy? My daughter is 51 years old, and this is the third time she has had it. She had it at ages 2 and 17. She thinks she looks like a monster, as she has no movement on the left side of her face. — E.B.

ANSWER: Bell’s palsy is a paralysis of muscles on one side of the face. Almost always, an affected person, upon looking in a mirror, believes he or she has suffered a stroke.

The eyelids on the paralyzed side can’t close. The mouth is drawn to the unparalyzed side, producing a somewhat grotesque appearance. Food and drink dribble from the mouth on the paralyzed side. Tastes sensation often is dulled. The eye with the involved lid dries due to decreased tear production. Sounds are heard louder than they actually are.

All of this comes about because of inflammation of the facial nerve, the nerve that serves facial muscles and taste sensation. The inflammation is believed to be caused by a virus or by a misdirected attack on the facial nerve by the immune system.

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A second recurrence, often years later, happens to about 7 percent of patients; a third to about 3 percent; and a fourth to 1.5 percent. Your daughter’s chance of another episode is quite slight. She’s already had more than her share.

On the upbeat side, about 80 percent of people will make a substantial recovery in a few weeks to a month. Some are left with a lingering weakness of those muscles and must enter a rehab program.

Treatment is a bit controversial. Some doctors prescribe one of the cortisone drugs early in the course of the illness. The affected eye has to be protected with a patch at night or with paper tape to keep the lid closed. Artificial tears are needed during the day.

DEAR DR. DONOHUE: I have tinea versicolor on my neck, shoulders and forehead. My husband got it from me. The doctor gave us Selsun Blue cream. It worked the first two times, but it always comes back. What makes it go for good? — R.S.

ANSWER: Tinea versicolor is a fungal infection of the skin. Infected skin loses its color. The result is pale patches of skin next to normal skin. When normal skin tans, the pale patches are very obvious. Selenium sulfide, the main ingredient in Selsun Blue, used daily for two weeks, gives good results. However, you have to continue to use it for a protracted period once weekly, or the fungus returns. Ketoconazole cream and ciclopirox gel also work. They require a prescription. They, too, should be used for extended periods. The skin remains depigmented for many months after treatment. Don’t take that as a sign that treatment failed.

DEAR DR. DONOHUE: You have left the bowel-problem people down. Please answer.

Does barometric pressure have any effect on bowel movements? Does a person have to go every day? If I drink water, then I have to get up at night. How much water should I drink? All tests show I have cysts in my kidneys. What does that mean? My brain scan shows I had a slight stroke. What’s that indicate? Please answer. I am 84 years old. — Anon.

ANSWER: I have never read or heard that barometric pressure has any effect on bowel movements. You do not have to have a bowel movement daily. Three movements in one week are sufficient. More important than frequency is the consistency of the movement. Rock-hard stools indicate a lack of fiber and fluid. You should drink enough water that the color of your urine is pale yellow or it has no color. Kidney cysts are not always troublemakers. Their size and their number might interfere with kidney function. No doctor in your 84 years has said they are causing trouble. I take that to mean they are not. Brain scans often show evidence of a small stroke, usually not indicating any serious problem.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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