Dr. Helm has been practicing interventional pain management since 1982. Dr. Helm is a diplomate of the American Board of Anesthesiology with subspecialty certification in Pain Medicine and of the American Board of Pain Medicine. Dr. Helm is a Fellow of Interventional Pain Practice (FIPP), the only certifying agency which tests the ability to perform interventional pain procedures. Dr. Helm is also an examiner for FIPP.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Bell's palsy occurs when the nerve that controls the facial muscles is
swollen, inflamed, or compressed, resulting in facial weakness or paralysis.
Exactly what causes this damage, however, is unknown.
Many scientists believe that viral infections such as the virus the causes
cold sore virus -- herpes simplex -- can cause the disorder. They believe that
the facial nerve swells and becomes inflamed in reaction to the infection,
causing pressure within the Fallopian canal and leading to ischemia (the
restriction of blood and oxygen to the nerve cells). In some mild cases (where
recovery is rapid), there is damage only to the myelin sheath of the nerve. The
myelin sheath is the fatty covering-which acts as an insulator-on nerve fibers
in the brain.
The disorder has also been associated with influenza or a flu-like illness,
headaches, chronic middle ear infection, high blood pressure, diabetes,
sarcoidosis, tumors, Lyme disease, and trauma such as skull fracture or facial
injury.
SOURCE: National Institute of Neurological Disorders and Stroke. Bell's Palsy
Fact Sheet.
What is the facial nerve?
The facial nerve is a nerve which controls the muscles
on the side of the face. It allows us to show expression, smile, cry, and wink.
Injury to the facial nerve causes a socially and psychologically devastating
physical defect; treatment may require extensive rehabilitation or multiple procedures.
The facial nerve is the seventh of the twelve cranial nerves. Everyone has
two facial nerves, one for each side of the face. The facial nerve travels with
the hearing nerve (the eighth cranial nerve) as it travels in and around the
structures of the middle ear. It exits
the front of the ear at the stylomastoid foramen (a hole in the skull base),
where it then travels through the parotid gland. In the parotid gland it divides into many branches which provide motor function for the
various muscles and glands of the head and neck.
What are symptoms of a facial nerve problem?
Facial nerve problems may result in facial muscle
paralysis, weakness, or twitching of the face; dryness of the eye or the mouth;
or alteration of taste on the affected side. However, the finding of one of
these symptoms does not necessarily imply a specific facial nerve problem; your
physician needs to make a careful investigation in order to make a precise
diagnosis.
What conditions affect the facial nerve?
There are numerous causes of facial nerve disorder:
Trauma: such as birth trauma,
skull base fractures, facial injuries, middle
ear injuries, or surgical trauma.
Nervous system disease: including Opercular syndrome, Millard-Gubler
syndrome.
Infection: of the ear or face, or
herpes zoster of the facial nerve
(Ramsey-Hunt syndrome).
Herpes simplex infections are common and when they appear around the mouth and lips, people often refer to them as "cold sores" and "fever blisters." Canker sores are different than cold sores. Air droplets can spread the virus, as can direct contact with the fluid from the blisters. Cold sore treatment include over-the-counter medication as well as prescription medications.
Diabetes mellitus is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
Genital herpes, a viral infection by the herpes simplex virus (HSV), is transmitted during sexual contact with the mucous-covered linings of the mouth, vagina, or the genital skin. A typical outbreak begins with an itching or tingling sensation followed by redness of the skin and blister formation. The blisters and ulcers that form when the blisters break are painful to the touch, and last from 7 days to 2 weeks. Though there is no cure for herpes, there are ways to treat outbreaks.
Lyme disease is a bacterial illness, which is spread by ticks when they bite the skin. Initially the disease affects the skin causing a reddish rash associated with flu-like symptoms. It takes weeks to months after the initial redness of the skin for its effects to spread throughout the body. Lyme disease can be treated with antibiotics. Lyme disease can be prevented by using tick avoidance techniques.
Alcoholism is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law.
Fractures occur when bone cannot withstand the outside forces applied to the bone. Fractures can be open or closed. Types of fractures include: greenstick, spiral, comminuted, transverse, compound, or vertebral compression. Common fractures include: stress fracture, compression fracture, rib fracture, and skull fracture. Treatment depends upon the type of fracture.
Diabetic Neuropathy is a complication of diabetes that causes damage to the nerves; this is related to the blood glucose of the body being too high for a long period of time. The four types of neuropathy include peripheral, autonomic, proximal and focal.
Neuropathic pain is chronic pain resulting from injury to the nervous system. The injury can be to the central nervous system (brain and spinal cord) or the peripheral nervous system (nerves outside the brain and spinal cord).
Pain management and treatment can be simple or complex, according to its cause. There are two basic types of pain, nociceptive pain and neuropathic pain. Some causes of neuropathic pain includes: complex regional pain syndrome, interstitial cystitis, and irritable bowel syndrome. There are a variety of methods to treat chronic pain, which are dependant on the type of pain experienced.
Ramsay Hunt syndrome is an infection of a facial nerve that causes a red painful rash with blisters and facial paralysis. The herpes zoster virus causes the infection. The infection is treated with antiviral agents, steroids, and pain medications.
A corneal ulcer is an open sore on the cornea. Infection is a common cause of corneal ulcer. Symptoms and signs of corneal ulcer include redness, eye pain and discharge, blurred vision, photophobia, and a gray or white spot on the cornea. Treatment depends upon the cause of the corneal ulcer.
Pregnancy planning is important to help prevent exposure of the mother and fetus to potentially harmful medications and substances during the early days, and throughout the pregnancy. Nutritional planning, prevention of birth defects, conditions such as high blood pressure, heart disease, diabetes, and kidney disease need careful monitoring. Gestational diabetes, preeclampsia, and pregnancy induced hypertension are conditions that may arise during pregnancy. Immunizations, inherited disorders, exercise, air travel, intercourse, and birth control are important factors to consider when planning a pregnancy.
Pain that originates in the face is referred to as trigeminal neuralgia. This pain may be caused by an injury, and infection in the face, a nerve disorder, or it can occur for no known reason. Trigeminal neuralgia can be treated with antiseizure medications. Some antidepressant drugs also have significant pain relieving effects.
Pregnancy can bring challenges like weight gain, stretch marks, varicose veins, heartburn, constipation, hemorrhoids, problems sleeping, and wondering if it is safe to have sex while pregnant. Learn how to manage and move through these challenges during pregnancy.
Lyme disease is a bacterial illness that is spread by
tick bites.
Lyme disease can affect the skin, joints, heart, and
the nervous system.
Lyme disease occurs in phases -- the early phase
beginning at the site of the tick bite with an expanding ring of redness.
Lyme disease is diagnosed based on the patient's
clinical signs of illness and the detection of Lyme antibodies in the blood.
Lyme disease is treated with antibiotics.
What is Lyme disease? What causes Lyme disease?
Lyme disease is a bacterial illness caused by a bacterium
called a "spirochete." In the United States, the actual name of the bacterium is
Borrelia burgdorferi. In Europe, another bacterium, Borrelia afzelii, also causes Lyme disease. Certain ticks found on deer harbor the bacterium in their stomachs. Lyme disease is spread by these ticks when they bite th...
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