Is Ibuprofen Good For Bell’s Palsy & What About Vitamin B12?

In the great majority of cases, Bell’s palsy gradually resolves over time, and its cause is unknown.(1)

A grading system was developed by House and Brackmann and it categorizes Bell’ s palsy on basis of severity and has a scale ranging from I to VI.(1)

Is Ibuprofen Good For Bell’s Palsy?

Bell’s palsy is a cranial nerve palsy affecting the 7th cranial nerve and is usually acute in onset. It is a self-limiting condition that gets cured by itself without any prolonged impairment in the majority of the cases. However, it may take weeks to months while correcting because nervous tissue is a slowly regenerating tissue. Also, when there is nervous tissue breakdown, it is associated with pain in the area supplied by that particular nerve. So, in many of the cases, Bell’s palsy is associated with pain in the facial region and may present itself as bouts of pain or a continuous dull aching area.

For the management of neuralgia associated with Bell’s palsy, non-steroidal anti-inflammatory drugs are recommended because they are very effective in dealing with pain. Although there may be a requirement of stronger anesthetic measures in few cases most of the time NSAIDS is enough.

Ibuprofen is one of those NSAIDS which are very powerful analgesic agents and can relieve even neuralgic pain by oral dosing. It not only helps to reduce the frequency of bouts of pain but also improves the quality of life in many cases of bell’s palsy (2). Other NSAIDs for pain management of bell’s palsy are acetaminophen, naproxen, ketorolac, etc. which can be given in the contraindication of ibuprofen but ibuprofen remains the best NSAID for pain relief.

Is Vitamin B12 Good For Bell’s Palsy?

Vitamin b 12 also known as cyanocobalamin is a vitamin of b complex which is responsible for a variety of functions in the body. One of its functions is to maintain the myelin sheath of the nerve and provide adequate nutrition for the regeneration of the nerve. Deficiency of vitamin B12 can lead to a decrease in the formation of the myelin sheath and also the regeneration process halts. It may lead to dysfunction of various peripheral nerves its deficiency disease known as pernicious anemia is a type of peripheral neuropathy only.

It is also known to affect cranial nerves, especially 5th (trigeminal) and 7th (facial) cranial nerves. These can be affected together or in isolation to each other and can cause a condition known as neuralgia. It can be treated with a booster dosage of Vitamin B12 if it gets diagnosed. The dosage for deficiency of Vitamin B12 is about 1000 micrograms given intramuscularly.(3)

Although much of the research is not done on the relationship of vitamin B12 and Bell’s palsy if it is associated with facial neuralgia or painful facial movements then treatment with external vitamin b 12 booster can be justified. So, it can be useful only in particular cases and there is no recommendation on regular usage of vitamin B12 in Bell’s palsy.(4)

Conclusion

Bell’s palsy is sometimes associated with neuralgic pain which occurs due to the breakdown of nervous tissue and has to be countered because it can take a lot of time to recover completely. For the time being and to relieve the patient from pain, the NSAID group of drugs can be used. These are strong analgesic agents with very few side effects and high ceiling of lethal dose and have almost no to very little abuse potential. Similarly, vitamin b 12 has also been used in some cases to speed up the regeneration process of nerve.

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