American Medical Association Family Medical Guide - American Medical Association [438]
WARNING!
Weakness or Numbness
If you experience muscle weakness or loss of sensation anywhere in your body, call your doctor immediately. If you can’t reach your doctor, call 911 or your local emergency number. These symptoms require immediate medical attention to prevent permanent damage.
Diagnosis
To diagnose an epidural abscess, a doctor will recommend a CT scan (see page 112), an MRI (see page 113), and, in some cases, an X-ray examination of the spinal cord called myelography. He or she will also take blood samples to identify the bacterium that caused the abscess.
Treatment
Antibiotics are usually the initial treatment for an epidural abscess. If an abscess is putting pressure on the brain or spinal cord, surgery may be necessary to relieve the pressure and prevent permanent damage. For the surgical procedure, the doctor makes an opening in the skull or in the spine to remove the pus. After the surgery, treatment with antibiotics is continued to eliminate the bacteria.
Other Brain and Nervous System Disorders
Some disorders of the nervous system do not fit easily into a precise classification. Some neurological disorders, such as carpal tunnel syndrome, develop when nerves are injured. Others, such as Bell’s palsy and Guillain-Barré syndrome, may be triggered by an infection. For many of these disorders, the cause is not known, and the symptoms can vary from person to person.
Bell’s Palsy
Bell’s palsy is a relatively common disorder of the facial nerves that results in weakness of the facial muscles. The facial nerves, located on each side of the face, pass through an opening in the skull just behind each ear. Bell’s palsy occurs when a facial nerve swells and presses on the opening in the skull. Some doctors think that a virus such as the herpes simplex virus may be the cause. Bell’s palsy is usually a temporary condition that comes on suddenly at any age, occurs on only one side of the face, and does not recur. The major risk is of dryness of and irritation or injury to the eye on the affected side because the eyelid muscles cannot close to protect it.
Symptoms
The recognizable symptom of Bell’s palsy is muscle weakness on one side of the face from the forehead to the mouth. This weakness is characterized by a drooping mouth, an inability to close the eye, and distortion of facial expressions. In some cases, taste is impaired because the facial nerve that carries signals from some taste buds of the tongue is affected. Sounds may seem unnaturally loud because a nerve to the stapedius muscle of the ear (which normally dampens sound) is also affected. Sometimes a person has pain near the ear or on one side of the face and a middle ear infection or sore throat.
Diagnosis
A doctor can usually diagnose Bell’s palsy by a physical examination and the person’s health history. Sometimes it is necessary to rule out other possible causes of the muscle weakness, such as a stroke (see page 669).
Treatment
To treat Bell’s palsy, your doctor may prescribe a corticosteroid medication such as prednisone to reduce inflammation and relieve pain. If your Bell’s palsy is the result of a herpes simplex virus infection, your doctor may also prescribe the antiviral medication acyclovir. If your eye won’t close, he or she will recommend wearing a protective eye patch and applying an eye ointment or eyedrops to protect and lubricate the exposed eye.
If the weakness in your face improves in 2 to 3 weeks, you will probably recover fully. However, if the first signs of returning muscle function do not begin within 2 months, recovery may take longer. In rare cases of permanent disfigurement, surgery may help improve a person’s appearance.
Multiple Sclerosis
Multiple sclerosis (MS) is an autoimmune disease in which the body’s immune system mistakenly attacks and destroys myelin. Myelin is an insulating material that covers nerve cells throughout the central nervous system