Bell’s palsy and The Vagus Nerve. Are they related?

Bell’s palsy

Multiple sources report an annual incidence of about 23 cases per 100,000 persons in the United States, with recurrence happening at a rate of 8-12%.

A theory about the vagus nerve being involved in Bell’s Palsy was recently floated to me, and I thought it would be wise to dig around a little bit to help you understand the relationship a bit better.
Bell’s palsy primarily affects the facial nerve (cranial nerve VII), but in some cases it can involve other cranial nerves, including the vagus nerve (cranial nerve X). Here are the key points about the relationship between Bell’s palsy and the vagus nerve:

1. Typical Bell’s palsy:
Bell’s palsy typically affects only the facial nerve, causing weakness or paralysis of the facial muscles on one side[5][6]. This is the most common presentation.

2. Atypical presentations:
In some cases, Bell’s palsy can involve other cranial nerves in addition to the facial nerve. This is considered an atypical presentation[3].

3. Vagus nerve involvement:
When the vagus nerve is affected along with the facial nerve in Bell’s palsy, it is a rare occurrence. The vagus nerve controls functions such as swallowing, speech, and some aspects of taste[1][5].

4. Symptoms of vagus nerve involvement:
If the vagus nerve is affected, patients may experience symptoms such as:
– Difficulty swallowing (dysphagia)
– Hoarseness or changes in voice
– Reduced gag reflex
– Altered taste sensation in the back of the tongue[1][3]

5. Ramsay Hunt syndrome:
In some cases, what initially appears to be Bell’s palsy may actually be Ramsay Hunt syndrome, caused by the varicella-zoster virus. This condition can affect multiple cranial nerves, including the facial and vagus nerves[1].

6. Diagnostic considerations:
When multiple cranial nerves are involved, including the vagus nerve, it’s crucial to perform a thorough evaluation to rule out other potential causes, such as tumors, stroke, or other neurological conditions[3][5].

7. Treatment:
The treatment approach for Bell’s palsy with vagus nerve involvement is similar to typical Bell’s palsy, often including corticosteroids and possibly antiviral medications. However, the prognosis may be more variable when multiple nerves are affected[5][6]. Acupuncture has been utilized by many who claim that their Bell’s palsy improved with acupuncture.

Can chiropractic care affect the vagus nerve?

The following is a list of ways in which chiropractic adjustments may impact the vagus nerve. The degree to which this may affect Bell’s Palsy when the vagus nerve is involved is still not clear, although anecdotal evidence suggests that it may improve outcomes in patients affected by Bell’s Palsy. 

1. Spinal alignment and nerve pressure relief:
   Chiropractic adjustments aim to realign the spine to promote better brain function and communication to and from the body. This can alleviate pressure on nerves, including the vagus nerve. This may reduce or prevent symptoms associated with vagus nerve dysfunction. 
2. Improved nervous system communication:
   By correcting spinal misalignments (subluxations), chiropractic care can enhance communication between the brain and the body, potentially optimizing vagus nerve function, which in turn should impact those structures and functions controlled by the vagus nerve
3. Vagus nerve stimulation:
   Chiropractic adjustments, particularly those focused on the upper cervical spine, may stimulate the vagus nerve, promoting better overall function in the nerves and throughout the body in those tissues and structures controlled by the vagus nerve.
4. Heart rate variability (HRV) improvement:
   Research from 2018 showed that chiropractic adjustments can boost vagus nerve function by positively impacting heart rate variability, which is controlled by the vagus nerve.
5. Autonomic nervous system regulation:
   Chiropractic care can help regulate the autonomic nervous system, potentially activating the parasympathetic system (which the vagus nerve is a major part of) to balance the sympathetic system. The autonomic nervous system controls the automatic functions of the body, like breathing, heart rate, digestion and a host of others.
6. Potential effects on various bodily functions:
   By influencing the vagus nerve, chiropractic care may contribute to improvements in digestion, inflammation reduction, and mental well-being.
7. Long-term benefits:
   One study indicated that long-term chiropractic care (52 weeks) resulted in sustained improvements in heart rate variability, suggesting ongoing positive effects on vagus nerve function.

 

While Bell’s palsy primarily affects the facial nerve, involvement of the vagus nerve can occur in atypical cases. Although this involvement is rare it can lead to additional symptoms related to swallowing, speech, and taste. Proper diagnosis and management are crucial in these cases to ensure the best possible outcome. More evidence would be useful in determining the benefits of chiropractic care and Bell’s Palsy, but most people affected would be thrilled with improvement of any kind, in the hope that complete resolution of symptoms is in their future. Chiropractic care if helpful in this process, even at an individual level, will likely make it worth trying for many afflicted with Bell’s Palsy.

Dr. Lou Jacobs has been a a chiropractor and acupuncturist in Portland, Maine for over 22 years. He has seen many dozens of patients with Bell’s palsy, many of which have improved in record time while under his care. Dr. Lou does not treat Bell’s palsy, but rather helps improve the function and overall well being of the entire body in an effort to contribute to a body that is better able to adapt and heal in the presence of stressors and dysfunction. 

Citations:

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7509732/

[2] https://jamanetwork.com/journals/jamaotolaryngology/article-abstract/608422

[3] https://www.emra.org/emresident/article/bells-palsy

[4] https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/bells-palsy

[5] https://www.hopkinsmedicine.org/health/conditions-and-diseases/bells-palsy

[6] https://www.msdmanuals.com/home/brain-spinal-cord-and-nerve-disorders/cranial-nerve-disorders/bell-palsy

[7] https://pubmed.ncbi.nlm.nih.gov/10695899/

 

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