On September 29, 2011, cricketer Rahul Sharma made it to the squad that will take on England in the upcoming five-match series. Experts provide details on the form of temporary facial paralysis that left the 25-year-old with blurry vision and low confidence during the 2010 IPL; a condition that he has since managed to overcome

Leg spinner Rahul Sharma will represent the country in the upcoming England tour of India series that kicks off on October 14. Things, however, haven't always looked as rosy for the player, who has Bell's Palsy.

The disease is a temporary weakness or paralysis of the muscles on one side of the face, says physiotherapist, Samidha Bhingarde, Surgicare Hospital. "These muscles are controlled by the facial nerve.
Because there is a facial nerve on each side of a person's face, and Bell's Palsy typically affects just one nerve, people with the condition are likely to experience stiffness or weakness on one side of the face," she explains.

Treatment options
According to neurologist Girish Nair, Fortis Hospital, Bell's Palsy can be treated over a period of two weeks with a combination of steroids and anti-viral agents, accompanied by physiotherapy and electrical stimulation of the affected nerve.

The recovery period can range from one month to a year. Facial exercises, electrical stimulation, manual massage and Kabat rehabilitation are among the physiotherapy treatment options available.

"Kabat is a motor-control rehabilitation technique based on proprioceptive neuromuscular facilitation.
Through verbal and manual input, the therapist motivates the patient and facilitates the voluntary contraction of the impaired muscle," explains Bhingarde.

Exercises to overcome the condition involve basic facial movements, using the different muscle groups in the face. Examples include furrowing and raising the eyebrows and blinking the eyes slowly.

"One should not exert oneself or worry about whether or not one is able to complete the exercises," says Bhingarde.

"The exercises are intended to work your mind more than your muscles." Following a balanced diet, coupled with good rest are also recommended.

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Vidya Karane, physiotherapist, LH Hiranandani Hospital, says that massage techniques, including effleurage, finger or thumb kneading, hacking, tapping and stroking are also effective. "Soft tissue massages help tone muscles," explains Karane.

Alternative therapy
Acupuncture, the traditional Chinese medicine that involves the insertion of needles into various parts of the patient's body by an experienced practitioner is typically a last-resort option for most.

"Acupuncture can completely cure Bell's Palsy," claims acupuncturist Tushar Patwa, who takes the patient's lifestyle and energy levels into consideration before starting him/ her on the treatment.

Cause: Still unknown
"The cause for Bell's Palsy is not clear," says Nair. Patwa, on the other hand, believes that (physical) overwork and exposure to strong winds distorts the air balance in the middle ear, thus affecting the facial nerves, which results in the condition.

Symptoms typically show up about a week or two after a viral infection. Headaches and ear pain, which can strike days or hours prior to doctors being able to diagnose the disease is another symptom, apart from dropping and stiffness on one side of the face.

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Difficulty in closing the eyes, the inability to frown or wrinkle the forehead, or to whistle or blow are some of the complications that can arise from weakness in the facial muscle, according to Nair.

He adds, "A crooked smile with the angle of the mouth deviating to the unaffected side, collection of food and saliva in the pouch between the paralysed cheek and tongue, and drooling are other complications that can result."

Patients might also experience a loss in their sense of taste, as well as a heightened sense of hearing, leading to painfully loud sounds.

Bell's Palsy can strike both men and women at any age. Recurrences are, however, rare.

According to Karane, people between the ages of 20 and 40 are at a higher risk of being affected by the condition. Pregnant women and those with diabetes are also in the high-risk category.

Emotional toll
Coping with Bell's Palsy also takes an emotional toll on the person and his/ her loved ones. "It is not contagious, but it does affect how your face looks for a while.
Being teased can hurt," says Bhingarde, who advises confiding in someone or seeing a counselor to cope better.

The year in which Charles Bell, the Scottish anatomist, who first described the disease that would then be known as Bell's Palsy, was born.

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