Bell’s Palsy Diagnosis
Story
I normally work on Saturday mornings for all the people who say they can’t make it during the week. I had to go to a seminar one Saturday but checked my messages when I got home. One of my patients had tried calling me that morning about a headache he had for the last 2 weeks (remember they can only make it on Saturdays?). I told him since I wasn’t available that day for him to come in on Sunday.
Exam
He shows up Sunday morning not only with the headache, but also the right side of his face numb! This is not a good thing! I check his BP, which was high (likely due to the stress of the situation!) and did a cranial nerve exam. Cranial nerves come directly off the brain and supply and supply sensation to the face. He is dull to sensation on the right side. He also says when he smiles only half the face works! Uh oh! He also can’t wink the eye on the right side. His upper arm reflexes were normal and muscle strength good.
Diagnosis
Any time you have cases like this you have to differentiate from a possible stroke. A good rule of thumb with stroke is the mnemonic “FAST” which stands for F: facial drooping, A: arm weakness, S: Slurred speech, T: Time to call 911!
So now we have narrowed it down to the 7th cranial nerve also known as the Facial Nerve. It supplies the muscles in the face and when it is affected in this manner it is known as a Bell’s Palsy. Also I should mention that half his tongue was numb. This nerve also supplies sensation to the front part of the tongue.
Treatment
Now knowing this was not a stroke or other major serious neurological problem, I adjusted his neck which offered relief of his headache. The patient was instructed to follow up with his medical doctor the next day, which he did.
Cases like this have come into the office occasionally over the years but this was the first time it was up to me to figure out what was wrong and diagnose Bell’s Palsy. His M.D. said I was right.
Robert Ebeling, DC is a Englewood Chiropractor. Office phone is (303) 377-1755.