Notes on Bell’s Palsy

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Yesterday I was involved with a DMA defense of an interesting project on overuse injury prevention in string players. A number of the topics that were addressed in the project had parallels in wind playing, but there are other topics that are beyond what are seen in string playing that can impact a brass player pretty dramatically. While not an overuse injury, in preparing for that defense one condition that came to mind for me was Bell’s palsy.

I have had contact with two brass colleagues who had bouts with this in my career as a hornist. It is a type of partial facial paralysis and before you panic too much, in both cases the condition corrected itself in a couple weeks. But in both cases half of the players face was actually paralyzed which is a frightening thought! The introduction to this topic in the Wikipdeia is a good overview.

Bell’s palsy is a paralysis of cranial nerve VII (the facial nerve) resulting in inability to control facial muscles on the affected side. Several conditions can cause a facial paralysis, e.g., brain tumor, stroke, and Lyme disease. However, if no specific cause can be identified, the condition is known as Bell’s palsy. Named after Scottish anatomist Charles Bell, who first described it, Bell’s palsy is the most common acute mononeuropathy (disease involving only one nerve) and is the most common cause of acute facial nerve paralysis.

Bell’s palsy is defined as an idiopathic unilateral facial nerve paralysis, usually self-limiting. The trademark is rapid onset of partial or complete palsy, usually in a single day.

It is thought that an inflammatory condition leads to swelling of the facial nerve. The nerve travels through the skull in a narrow bone canal beneath the ear. Nerve swelling and compression in the narrow bone canal are thought to lead to nerve inhibition, damage or death. No readily identifiable cause for Bell’s palsy has been found.

Both of the individuals I had contact with seem to have had it caused by the “inflammatory condition” noted above. Again, it is a medical condition not an overuse injury but it is something to be aware of as something that could deeply impact a wide variety of musicians.

Returning to the topic of overuse injury, it is a good topic and I will return to it in future posts. Among prior Horn Matters posts, I have a few notes on prevention of overuse injury here, and Bruce has posted on the topic of focal dystonia here. Also ergonomics is an element of overuse injury relating to our left arm and hand; check out the strap on Fhrap tm in this post.

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