You are unsure what is causing this and become concerned.
You see a doctor shortly after who after assessing you, prescribes you with corticosteroids and an antiviral to treat the diagnosis of Bell’s Palsy.
Still making no progress with your facial paralysis even though you have followed doctors order and taken medication faithfully, and even went online to try facial exercises , you decide to recheck with your doctor as the facial paralysis is taking a physical, emotional and social toll on you.
This is a not too uncommon scenario for people that suffer with recent and sudden onset of facial paralysis. Especially if you live in the north midwest and Eastern United States and Canada. Especially if you enjoy the outdoors, hiking/ taking strolls in the woods and tall grassy areas.
Even though the symptoms, at first, resemble the ones for Bell’s palsy, you would actually be dealing with a completely different pathology: Lyme disease.
Lyme disease affects more than 300,000 Americans each year. This condition arises from the bite of a blacklegged tick, or “deer tick” that leads to a bacterial infection. Just like Bell’s plalsy, the symptoms vary greatly between individuals.
In the previous case, I use the exemple of a rash but know that many patients do not develop a rash at all, even though it remains the most common initial symptoms.
If you have any of these symptoms, even if you don’t remember being bitten by a tick or remember an abnormal rash on your body, I would suggest you discuss all this with your physician. You can bring up Lyme disease to them.
Why is this important? Because the two are treated with different medications, which will not help cure the other condition. And also because facial paralysis could be the only and first Lyme disease’s symptoms currently present. It is often missed. And, sadly, it can lead to a stage of Lyme disease that is much harder to treat.
When should you bring it up? As soon as possible!
Both Bell’s Palsy and Lyme involves your nervous system, one of the body system that takes the longest to heal... The earlier it is treated correctly, the more likely the treatment should be successful.
Lyme disease is caused by Borrelia burgdorferi, a bacteria and its symptoms tends to show up 7 to 21 days after the tick exposure.
The first thing to do if you know you have been bitten by a tick and experiences facial paralysis or any of the previously described symptoms: consult with your or a physician right away. And don’t omit talking about the tick bite. Facial paralysis from Lyme disease tends to have worse longterm outcome in general versus facial paralysis from Bell’s palsy.
Lyme disease is treated with antibiotics and Bell’s palsy with corticosteroids and antiviral.
Another difference is that Bell’s palsy rarely affects both side of the face... While it is much more common with Lyme disease.
The recovery also tends to happen faster in Bell’s palsy, with 3-4 months before any recovery can happen with Lyme disease. There are three stages of Lyme disease but reviewing these goes beyond the scope of this post.
So a diagnosis of Bell’s palsy versus Lyme disease is not always an easy one, even for a medical professional. If you suffer any of the symptoms mentioned in this post, make sure you do not leave any details when consulting with your physician.
Remember that more than 80% of a medical diagnosis is made from the subjective exam... The information the patients provides.
If you suffer from facial paralysis and are not sure what to do in regards to facial exercise to regain function, check our facial exercises tutorial:
Pierre-Yves Butheau, MPT, CMP has been a physiotherapist for 19 years and has a passion for helping people move better, return from and prevent injuries, as well as improve their function and quality of life. He has a strong interest in addressing the root cause of and treating neuro-musculoskeletal conditions while educating his patients with the knowledge to manage their conditions and prevent recurrence. Pierre also has a niche in treating Bell's palsy and temporomandibular joint dysfunctions.