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23 August, 2017, 02:52:07 pm
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Author Topic: 3 weeks with no improvement  (Read 175 times)
moomin94
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Posts: 5


« on: 12 August, 2017, 01:57:53 am »

Hi everyone, 
 I'm a 23 year old female and I'm struggling a lot at the moment. I have had my 10 days on the steroids and 7 days with the antiviral drugs and I have seen no improvement at all with the condition. I'm getting really worried. I noticed some tingling in my forehead and under-eye a couple of days ago which has stopped now, could that be a positive sign?
 I had electro-acupuncture for the first time today as I had read that it might be able to speed up recovery but I found it to be really uncomfortable and I don't know if I can continue receiving treatment twice a week for 8 weeks like the doctor said. I'm so desperate though, I have no confidence and hate leaving the house like this. I am so worried it won't get better.
Any advice would be greatly appreciated.
Thank you.
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DebbieL
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Posts: 419


« Reply #1 on: 12 August, 2017, 12:03:40 pm »

Please stop having your poor damaged face zapped with electricity. No, you cannot zap a damaged nerve back to life. What you can do is more damage and give yourself an incomplete recovery like I have, and/or damage that causes your eye to close or water when you try to smile or other cross wiring when your poor damaged nerve tries to work. Just stop it! Read this forum, you'll not find a single person to say electrostimulation healed them. I'm shocked (yes, sarcasm) that your doctor would prescribe this. Where do you live? No, no, no, it won't help. You're throwing your money away, causing yourself pain, and possibly making sure you won't have a complete recovery.

Read this forum! Rest, let your body heal, eat well, drink lots of water. There are no miracle cures. 3 weeks is a very short time. Yes, some people heal quickly, but not everyone. The more you stress and zap and push and shove and mangle your face, the harder your recovery will be. Just because someone recovered in a few weeks, don't let that make you think you're a failure if you don't.

Run away from that treatment, or should I say from that torture. Please, stop it.
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Bernadette
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Posts: 529


« Reply #2 on: 13 August, 2017, 09:25:12 am »

Hi!

I can understand the doctor you are seeing thinking that electroacupuncture may be a good way forward for you as there is research which indicates it is successful.  For example, if you read the results and discussion in this paper it seems a good way forward http://ayubmed.edu.pk/JAMC/PAST/22-4/Zahid.pdf

The rationale behind it is that it may prevent a damaged nerve going into Wallerian degeneration i.e. prevent the axon of the damaged nerve degenerating. However, that is just a theory.

That was research from Pakistan. 

There doesn't appear to be a UK view on electroacupuncture, but there is a suggestion on the NHS website that acupuncture may help http://www.nhs.uk/Conditions/Bells-palsy/Pages/Treatment.aspx
 
Electric stimulation harmed Debbie, and so there is clearly cause for concern.
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DebbieL
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« Reply #3 on: 13 August, 2017, 11:53:03 am »

Facial nerves do not atrophy for at least 18 months. Ridiculous to treat a damaged facial nerve with electricity
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Bernadette
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« Reply #4 on: 13 August, 2017, 04:44:52 pm »

What the researcher appears to be saying is that if recovery occurs within three weeks then there has been a reversible neurapraxia. Neurapraxia means temporary failure of conduction. http://ayubmed.edu.pk/JAMC/PAST/22-4/Zahid.pdf

If the recovery exceeds that time frame then Wallerian degeneration has taken place/will take place, and then nerve regrowth and reinnervation will have to occur. In those circumstances recovery will take 4-6 months and is more likely to be imperfect.

His theory is that the electoacupuncture can stop the Wallerian degeneration taking place in those people who have not had a spontaneous recovery. He claims to have had a 100% success rate with 49 patients who had not recovered within the initial three weeks.

However, there are some inconsistencies in his paper. In the methods section, he states that only patients who had not shown signs of recovery were included in the study, but in the discussion section he says:   "Long standing cases in which recovery had virtually stopped or was very slow, in them recovery was expedited and was satisfactorily completed in two weeks" so this casts some doubt on the patient group in the study.

It is thought to be years before facial muscles atrophy, but Wallerian degeneration undoubtedly occurs in damaged nerves as part of the healing process.

« Last Edit: 13 August, 2017, 04:57:52 pm by Bernadette » Logged
DebbieL
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Posts: 419


« Reply #5 on: 13 August, 2017, 09:07:43 pm »

When all is said and done, each and every case of facial palsy is unique, even separate episodes for the same person.  Most people will recover no matter what they do, but that's most, not all.  If the damage is minimal, recovery should be quicker, but isn't always. There is no definitive answer.  BUT... the safest thing is to let your body heal naturally.  Yes, many people take steroids to lessen the inflammation. Yes, many people take anti-virals in case the cause is viral in their case.  But people who force movement, whether by early aggressive massage, physiotherapy, electrical stimulation, or facial exercises, are asking for trouble.  They may do just fine, but why chance it? 

Patience is a lost art.  Too many people want everything NOW!  We all need to relax, rest, treat our bodies with respect, and seriously, take a deep breath! 

Force is never the answer. 
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Bernadette
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« Reply #6 on: 14 August, 2017, 07:23:28 am »

Yes Debbie, I agree, the body has wonderful recuperative properties and we can help those by eating well and avoiding too much stress.

People also have facial paralysis for different reasons and therefore treatment should be tailored to the underlying cause. It often isn't because there is no initial investigation into the cause of the facial paralysis.

It may also be the case that a nerve injury when there is minimal damage may take longer than three to four weeks to recover.

An issue though is that people who recover quickly (significant improvement quite quickly)  tend not to have synkinesis i.e.  80-85% of people with Bell's palsy are quite fortunate.

Those who take longer to recover  (about 15%-20%  of cases) or who may have Ramsay Hunt are more likely to develop synkinesis.

The author argued that  making the damaged nerve conduct again by shocking it  back into action would prevent it degenerating, and therefore avoid the need for regrowth.

However, if the nerve is badly damaged then perhaps the right thing is for that nerve to be replaced by the body even though there can be problems with the regrowth and the reinnervation?

Also if you read his paper carefully, you can see that people who received the electro-acupuncture still had "a mild to moderate effect at the angle of the mouth".

There was also no follow-up. What happened to the 49 subjects? Did any or all of them subsequently develop synkinesis or had he prevented that?  
« Last Edit: 14 August, 2017, 07:36:25 am by Bernadette » Logged
Bernadette
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« Reply #7 on: 14 August, 2017, 07:51:01 am »

I have had a look to see what else I can find about electroacupuncture and its side effects. There isn't much actually.

In a Chinese study people who had electroacupuncture with administration of a herb had a better outcome than those who just had electroacupuncture. Significantly, 8 out of 52 who had electroacupuncture on its own had complications i.e. about 15% https://www.ncbi.nlm.nih.gov/pubmed/24494279

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clarebear
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Posts: 10


« Reply #8 on: 14 August, 2017, 05:45:31 pm »

Hi Moomin94,


I am in a similar situation to you, just a little further along time wise. I was diagnosed 2 weeks ago last Saturday. I was given steroids the day it happened (Saturday) and antivirals on the Monday. I had a terrible time on the steroids and felt awful and still am not right even though they finished nearly a week ago. I have been taking it easy. The right side of my face is the effected side and is fully paralysised as far as I understand it. Saturday I have a tiny amount of what looks like twitching under my eye if I try to close my eyes. I take this as a good sign that some signal is getting through. I am not forcing it as all advice says not too. Just glad there is some improvement, even just a tiny but it is something. Tingling is good too. Don't forget it is still early days for you. I was starting to get down as well, at not seeing any improvement. I hope it helps to know you are not alone.

Please try not to worry and look after yourself, eat well, especially B vitamins, fresh fruit and veg and rest if you can.

All the best,
Clare
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moomin94
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Posts: 5


« Reply #9 on: 14 August, 2017, 06:12:20 pm »

Thank you clarebear, I am making sure to take my B vitamins and getting lots of rest as I have been given time off work to get better. This is such a scary time, I haven't had twitching for a while now and I'm trying not to panic but it is difficult! The steroids made me feel terrible too while I was on them, they made me very nauseous so I'm glad to be off them. Thank you for reassuring me, I hope we both start to see some improvement very soon!   

 Thank you for sending me those links Bernadette, I will take everything into consideration when thinking about whether to continue the electro acupuncture treatment. I much prefer the idea of resting and letting it heal that way, especially as the treatment was quite painful. But there does seem to be a lot to say that it can be beneficial, I am still in two minds about it.
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Bernadette
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Posts: 529


« Reply #10 on: 14 August, 2017, 09:12:29 pm »

Hi!

You need to consider a few questions:

1. Why is the doctor telling you you need to have this treatment for eight weeks? What is the rationale behind that?

2. Have any of his other patients who were treated with the electroacupuncture  developed synkinesis?

3. Are you partially paralysed or fully paralysed with the Bell's palsy? If you are partially paralysed then you are likely to recover fairly quickly anyway.

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