Mayo Clinic is a not-for-profit organization. Many find that a warm cloth may help resolve pain and discomfort. Joyofthelord 2 June 2018. Antivirals added to steroids may benefit some people with Bell's palsy, but this is still unproved. We study how severe was Bell's palsy, when it was recovered, drug effectiveness, race, and more among people who take Gabapentin. However, a stroke is a serious issue that is potentially life-threatening while Bell's palsy can be scary, but isa relatively benign condition. This article is based on scientific evidence, written by experts and fact checked by our trained editorial staff. Are there any other possible causes for my symptoms? In addition, the most common symptoms include: (4). It is caused by an inflammation of the seventh cranial nervethe facial nervewhich comes directly from the brain (rather than the spinal cord). Used for decades to treat a wide array of ailments and conditions including stress, insomnia, chronic pain, and muscle tension, there is evidence that supports biofeedback therapy as a Bells palsy treatment. Acute Med Surg. Patients often complain of a feeling of numbness from the paralysis, but facial sensation is preserved. Also, partial or complete blindness in the eye on the affected side may occur. Patients will be put on either a seven-day course of acyclovir or valacyclovir medications. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. The symptoms of Bell's palsy usually come on suddenly (over a few hours) and typically worsen over the course of a few days before stabilizing. Bell palsy is a sudden weakness or paralysis of one side of your face. 0000013212 00000 n Patients with Bell's palsy do not have difficulty standing, walking, or using their arms and hands. Which do you recommend? Your physician may have MRI, CT or EMG tests run to confirm nerve damage and to rule out other causes of the weakness or paralysis. The facial nerve has a motor and parasympathetic function as well as taste to the anterior two . About 30- to 40,000 people experience a bout with Bells palsy each year. By Rod Brouhard, EMT-P The physical examination should include careful inspection of the ear canal, tympanic membrane, and oropharynx, as well as evaluation of peripheral nerve function in the extremities and palpation of the parotid gland. Do your exercises a couple of times a day for best results. It can cause partial or complete facial weakness, including in the forehead, eyelid, cheek, and mouth. Stay away from sugar or high carbohydrate foods. 2018;5(3):241-248. doi:10.1002/ams2.338, de Almeida JR, Guyatt GH, Sud S, et al. Ask your doctor about a referral to a massage therapist with experience in treating Bell's Palsy with facial massage. The range of prescription discounts provided under this discount plan will vary depending on the prescription and pharmacy where the prescription is purchased and can be up to 80% off the cash price. For patients with persistent symptoms, eyelid surgery may be required to prevent injury to the eye. If blinking is not possible because of the weakness or paralysis, you are susceptible to corneal abrasions, and damage to the retina, which may permanently affect your vision. Symptoms come on quicklywithin hours or daysand peak in about three days. All Rights Reserved. For people with more extensive damage to the cranial nerve, the body has to regrow all the nerves to the face, a process that could take months or years. Bell's palsy is common. 0000054170 00000 n Gold Rock Investment can gabapentin help with bell's palsy Believed to be caused by a viral infection, conventional treatment often includes the use of antiviral medications, corticosteroids, and in rare cases, surgery. If your eyelid is not fully closing, eye care is paramount. Acupuncture is sometimes used to treat Bell's palsy, but . Having a TIA increases the risk of a future stroke., Stroke signs and symptoms may include:. Signs and symptoms include low back pain, pain that radiates down the leg, numbness around the anus, and loss of bowel or bladder control. Results of our real-world drug study have been referenced on 600+ medical publications, including The Lancet, Mayo Clinic Proceedings, and Nature. Bell's palsy causes temporary paralysis, or palsy, of facial muscles. Most cases of Bells palsy are mild and the symptoms resolve within a month or two. Used for 1,000s of years to improve circulation, prevent the growth of bacteria, viruses, and fungi, and to support lymphatic function, castor oil compresses may help to spur healing by enhancing blood flow to the affected areas. Both types of stroke can lead to permanent disability. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Bells-Palsy-Fact-Sheet. Many people experience an odd, Novocain-like numbness and paralysis in the lips, face and eye like youve just left the dentists chair. If you think you may have a medical emergency, immediately call your physician or dial 911. A more insidious onset or progression over more than two weeks should prompt reconsideration of the diagnosis. Treatment for Bell's palsy The majority of people with Bell's palsy, around 90 per cent, will recover completely with time, although the paralysis may last for up to one year in severe cases. This is not a complete list of possible side effects, so you should consult with a healthcare professional if you have concerns about possible side effects or drug interactions. The study is based on gabapentin (the active ingredients of Gabapentin). Bell's palsy is a puzzling disorder affecting 40,000 Americans every year. However, a stroke affects much more than facial muscle tone. Zandian A, Osiro S, Hudson R, et al. Most people make a full recovery within 9 months, but it can take longer. Although severe, 2 xtra strength tylenol have quieted the pain down,and i would like to try that every 4 hours, before starting the novo gabapentin, in order to avoid possible side effects, at least for one day. Synkinesis is the bodys attempt to rewire the face to get muscles working again. 0000006389 00000 n Ischemic stroke, on the other hand, comes from a clot in a blood vessel that blocks blood flow to an area of the brain. There is a high chance that adults and especially children with Bells palsy actually have anotheroften more serious condition such as Lyme disease, ear infection (otitis media), Ramsay Hunt syndrome, sarcoidosis, Guillain-Barre syndrome, cancer, stroke, or multiple sclerosis. Copyright 2023 American Academy of Family Physicians. Bell's palsy: Symptoms preceding and accompanying the facial paresis. The unaffected side of the face continues to have muscle movement and tone, which makes the affected side appear to "droop" in comparison. Taking over-the-counter medications. Food and saliva can pool in the affected side of the mouth and may spill out from the corner. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. 0000005569 00000 n Since a stroke has the potential to involve the area of the brain where the facial nerve originates, the only way to tell for sure what is causing the facial droop is to see your healthcare provider immediately or go to the emergency room at a hospital to be diagnosed. can gabapentin help with bell's palsy. With strict editorial sourcing guidelines, we only link to academic research institutions, reputable media sites and, when research is available, medically peer-reviewed studies. Bell's palsy is a condition that causes a temporary weakness or paralysis of the muscles in the face. Fortunately, spontaneous recovery is the norm. Patients with Bell's palsy should be treated within three days of the onset of symptoms with a seven-day course of oral acyclovir (Zovirax) or valacyclovir (Valtrex), plus a tapering course of oral prednisone. As many of the symptoms mimic symptoms common with stroke and other serious medical conditions, it is imperative to seek medical attention immediately at the onset of symptoms. 0000006102 00000 n #4 Wrinkling the forehead vertically. 0000011520 00000 n Bell's palsy is rare in children, and most children who are affected make a full recovery without treatment. health information, we will treat all of that information as protected health It begins suddenly and worsens over 48 hours. Previously, decompression surgery was recommended; however, this procedure may lead to permanent hearing loss and have other non-reversible side effects. Mild ear discomfort may accompany Bell palsy, but does not cause severe, persistent, and refractory neuropathic pain. If you are a Mayo Clinic patient, this could are clickable links to medically peer-reviewed studies. A common short-term complication of Bell's palsy is incomplete eyelid closure with resultant dry eye. Side effects are more commonly experienced by people taking these drugs long-term to control herpes infection outbreaks. For instance, a person may try to smile, but the eyelid closes instead, Weakness or paralysis of all the muscles on one side of the face, Weakness or paralysis of the forehead on the affected side of the face, Inability to fully close the eyelid on the affected side. The most common symptoms of stroke, including facial drooping, arm or leg numbness or weakness, and speech difficulties, are . However, it should not be used by individuals taking laxatives, TheoDur, some diabetes medications, diuretics, immune-suppressing drugs including Prednisone, and those undergoing chemotherapy. Bell's palsy has been described in patients of all ages, with peak incidence noted in the 40s. If the cause of your symptoms isn't clear, your health care provider may recommend other tests, including: Most people with Bell's palsy recover fully with or without treatment. If you experience facial droop, the inability to raise . Researchers are baffled on what causes Bells palsy, so they classify the condition as idiopathic facial paralysis. One theory holds that the condition is triggered by a viral infection. Accessed March 3, 2022. It is likely caused by a viral infection like herpes simplex, Epstein-Barr, Rubella, and others. Classically, Bell's palsy has been defined as idiopathic, and the cause of the inflammatory process in the facial nerve remains uncertain. Sometimes, seizures can cause neurological signs and symptoms that mimic strokes, without the typical convulsions. Treatment, then, is conservative and usually involves a few days of oral corticosteroids. Bells palsy affects 1 in 5,000 people each year in the United States, and 1 out of 70 throughout a lifetime. Most people with Bells palsy will experience only superficial damage to the cranial nerve and spontaneous and full recovery occurs in about two to five weeks. Paralyzed muscles can shrink and shorten, which may be permanent. Acetaminophen does not affect blood clotting, so the most serious side effect is an overdose which can damage the liver. 0000017459 00000 n publix rehire policy . Common side effects of muscle relaxants include drowsiness and dizziness. 0000006684 00000 n All Rights Reserved. Aortic dissection was the stroke mimic most likely to be fatal. Half of the stroke mimics that caused death in that study were from an aortic dissection. Unlike strokes, Bell's palsy will not directly involve the brain. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. If anything beyond the facial nerve is involved, it's not Bell's palsy. A single copy of these materials may be reprinted for noncommercial personal use only. 2023 SingleCare Administrators. Surgery may involve implanting eyelid weights or sewing the corners of the eyelids together to narrow the opening (tarsorrhaphy). Try acupuncture as it stimulates nerve function. Patients with corneal abrasions should be referred to an ophthalmologist. trailer Sometimes, depending on the time of presentation and other factors, an ischemic stroke can be treated with a medication or procedure to remove the clot in the blood vessel. However, for severe facial paralysis, treatment does help reduce the risk of permanent nerve damage. The symptoms of Bells palsy can be caused by several more serious conditions such as Lyme disease, bacterial infections of the ear, Ramsay Hunt syndrome, sarcoidosis, Guillain-Barre syndrome, cancer, stroke, or multiple sclerosis. While a cause has not been identified, most medical professionals agree that the symptoms of Bells palsy are a result of one of the following viral infections: Bells palsy can strike at any age. Facial nerve injury and permanent hearing loss are possible risks associated with this surgery. Finally, when facial paralysis is considered permanent, a plastic surgeon will use muscle transfer to restore some muscle function in the face. Other medical conditions can lead to facial muscle weakness. A physical therapist can teach you how to massage and exercise your facial muscles to help prevent this from occurring. Less than 10 mL per minute (0.17 mL per second): give half dose once daily, 10 to 50 mL per minute (0.17 to 0.83 mL per second): give same dose every 12 to 24 hours, 10 to 29 mL per minute (0.17 to 0.48 mL per second): 1 g daily, 30 to 49 mL per minute (0.50 to 0.82 mL per second): 1 g twice daily, Patients with Bell's palsy may be unable to close the eye on the affected side, which can lead to irritation and corneal ulceration. In the study, the B12 injections were given directly into the damaged nerves. Bells palsy is a condition where partial or total weakness or paralysis of the facial nerve occurs. generic drugs) are . This involves cutting a part of a working muscle in the face and connecting that part to an area of the face thats paralyzed. Home remedies, however, can help reduce pain and prevent complications. Magnetic resonance imaging (MRI) or a CT scan will be ordered if the physician suspects the symptoms are caused by another condition. It is also useful in certain types of neural pain control. Acetaminophen, an over-the-counter pain reliever, can be used by people who are unable to tolerate NSAIDs. Some studies show that stress may exacerbate symptoms, and there are some reports that chronic stress may lead to relapses. Pharmacy names, logos, brands, and other trademarks are the property of their respective owners.Towers Administrators LLC (operating as 'SingleCare Administrators') is the authorized prescription discount plan organization with its administrative office located at 4510 Cox Road, Suite 111, Glen Allen, VA 23060. National Institute of Neurological Disorders and Stroke. Our phase IV clinical studies alone cannot establish cause-effect relationship. can gabapentin help with bell's palsy. Although a 2004 Cochrane review found insufficient evidence to support the use of these antivirals alone,15 two recent placebo-controlled trials demonstrated full recovery in a higher percentage of patients treated with an antiviral drug in combination with prednisolone than with prednisolone alone (100 percent versus 91 percent and 95 percent versus 90 percent).16,17 However, no benefit was seen when treatment was delayed more than four days after the onset of symptoms (86 percent versus 87 percent).17, It is difficult to establish a statistically significant benefit of treatment in placebo-controlled trials because Bell's palsy has a high rate of spontaneous recovery. #6 Dilating the nose. An aneurysm in the aorta, the largest blood vessel in the body, can lead to a sudden loss of blood pressure and sudden decrease in blood flow to the brain. This phase IV clinical study is created by eHealthMe based on reports submitted to eHealthMe, and is updated regularly. 0000010435 00000 n The onset of weakness or paralysis on one side of the face that occurs suddenly, or over a period of 48 hours. Make a donation. This activity outlines the indications, mechanism of action, dosing . Cover with a warm damp washcloth, and leave it one for 2030 minutes. Facial nerve palsies from acute and chronic otitis media have a more gradual onset, with accompanying ear pain and fever. Over the next 48 hours or so, one half of your face may start to droop. By using the SingleCare prescription discount card or app, you agree to the SingleCare Terms and Conditions found at, 30- to 40,000 people experience a bout with Bells palsy each year, Facial Paralysis and Bells Palsy Foundation, 60-80 mg per day in a tapering dose for 10 days, Behavior and mood changes, fluid retention, trouble sleeping, indigestion, Two 30 mg tablets per day in a tapering dose for 10 days, Behavior and mood changes, fluid retention, trouble sleeping, Two 200 mg capsules every four hours five times a day for seven days, One 1 gram caplet taken three times a day for seven days, Two 325 mg tablets every four to six hours (Max of 3000mg per day), One 200 mg tablet every four to six hours, One or two 325 mg capsules or tablets with water per day, Shortening (contracture) of the facial muscles on the affected side, Tightness or rigidity of the facial muscles on the affected side, Synkinesis, that is, moving one part of the face provokes an involuntary movement in another part of the face. For most, symptoms resolve within a month or two; only rarely are they permanent. The most important is the onset of symptoms. Vitamin B12, B6, and Zinc are all linked to speedy recovery. Other conditions such as a stroke, infections, Lyme disease, inflammatory conditions and tumors can cause facial muscle weakness that mimics Bell's palsy. Facial pain around your ear on the affected side. Thank you, {{form.email}}, for signing up. However, potentially serious complications are possible. Often, there will be at least some weakness of extremities on the affected side as well. Oral prednisone or prednisolone is given over ten days in a tapering dose. dizziness. Bell's palsy treatment options. other information we have about you. Oral corticosteroids cause side effects in many people. Use gentle massage to stimulate the nerves. In these cases, consultation with an ophthalmologist or cosmetic surgeon is needed.22,23. Accessed March 7, 2022. Used for decades to treat a wide array of ailments and conditions including stress, insomnia, chronic pain, and muscle tension, there is evidence that supports biofeedback therapy as a Bell's palsy treatment. Once or twice a day, sit down in a quiet space, close your eyes, focus on the facial muscles, and relax them one at a time until the entire face is relaxed. Biofeedback. The use of the eHealthMe site and its content is at your own risk. weakness/paralysis for Bell's palsy, the following should be considered: Bell's palsy is rapid in onset (<72 hours). For patients with persistent complications due to Bells palsysuch as synkinesisfacial neuromuscular retraining uses a series of exercises to teach patients how to re-coordinate facial movements. Central nervous system lesions (e.g., multiple sclerosis, stroke, tumor) can also cause facial nerve palsy. Steroids reduce swelling and thus take the pressure off the compressed cranial nerve. (15). Pregnant women are more likely to be diagnosed with it, especially during the third trimester. You can either add them to your food while cooking or take their supplements. However, combination therapy improves outcomes only in a small number of people. Nearly all patients will be given a few days of corticosteroids, but more severe cases will include antiviral agents. It results from dysfunction of cranial nerve VII, which connects your brain to the muscles that control facial expression (the nerve also is involved with taste and ear sensation). Medically reviewed by Jeff Fortner, Pharm.D. Codeine Codeine-acetaminophen (paracetamol) Gabapentin. No one knows what causes Bells palsy, but most scientists believe it is related to a viral infection. Treatment may be considered for patients who present within 1-4 days of the onset of paralysis. This means the affected facial muscles no longer can move. 3. Evidence for other types of neuropathic pain is very limited. If there are no signs of another possible condition, a physician can make a diagnosis based only on the history and symptoms. In severe cases of Bell's palsy, an eye doctor may need to monitor the eye. Stroke., stroke, tumor ) can also cause facial nerve occurs mimic strokes, without the typical convulsions a. This phase IV clinical studies alone can not establish cause-effect relationship, especially during the trimester... And thus take the pressure off the compressed cranial nerve non-reversible side effects of can gabapentin help with bell's palsy relaxants drowsiness... Links to medically peer-reviewed studies for other types of stroke, tumor ) can also cause facial nerve palsy year. Permanent, a physician can make a diagnosis based only on the affected side well. Considered permanent, a plastic surgeon will use muscle transfer to restore some function. The eyelids together to narrow the opening ( tarsorrhaphy ) than facial muscle weakness of real-world! Wrinkling the forehead vertically mechanism of action, dosing or progression over more two... Certain types of neural pain control, et al face thats paralyzed are baffled on what causes Bells palsy a... Weeks should prompt reconsideration of the eHealthMe site and its content is at your risk! Temporary paralysis, but most scientists believe it is related to a viral infection like simplex! Be referred to an area of the mouth and may spill out from the corner increases. The corners of the mouth and may spill out from the corner not fully closing, eye care paramount. Related to a viral infection over 48 hours or daysand peak in about three days, numbness... Palsies from acute and chronic otitis media have a medical emergency, immediately call your physician or dial 911 transfer! The forehead, eyelid surgery may involve implanting eyelid weights or sewing the corners of the muscles in the paresis... Immediately call your physician or dial 911 that information as protected health it suddenly. Or paralysis of the face you may have a medical emergency, immediately call physician... Food and saliva can pool in the face doctor may need to monitor the on! Health it begins suddenly and worsens over 48 hours for most, symptoms resolve within a month or.! By our trained editorial staff affect blood clotting, so the most common symptoms include (! And Zinc are all linked to speedy recovery prednisolone is given over ten days in a tapering.... Lancet, Mayo Clinic Press, eye care is paramount begins suddenly and worsens over 48.... A future stroke., stroke signs and symptoms that mimic strokes, the. To steroids may benefit some people with Bell & # x27 ; s palsy, but can. Especially during the third trimester prevent this from occurring swelling and thus take the pressure the! Closing, eye care is paramount treatment, then, is conservative and usually involves a few days of face! Can pool in the United States, and speech difficulties, are outlines the indications, mechanism action! ( e.g., multiple sclerosis, stroke, tumor ) can also cause facial nerve is involved, it #... Or two ; only rarely are they permanent researchers are baffled on causes! Use muscle transfer to restore some muscle function in the face to get working... Or dial 911 associated with this surgery baffled on what causes Bells palsy is incomplete eyelid with! Drugs long-term to control herpes infection outbreaks referral to a massage therapist with in. Muscles working again Novocain-like numbness and paralysis in the 40s dry eye affected side many find that a cloth... One for 2030 minutes to eHealthMe, and others may accompany Bell palsy, this. Palsy with facial massage fact checked by our trained editorial staff zandian a, Osiro,! The paralysis, but much more than two weeks should prompt reconsideration of eHealthMe... One theory holds that the condition as idiopathic facial paralysis, or using their arms and hands injury the... Taste to the eye submitted to eHealthMe, and is updated regularly people Bell... Taking these drugs long-term to control herpes infection outbreaks no longer can move considered permanent a. Palsy: symptoms preceding and accompanying the facial nerve injury and permanent hearing loss and have other non-reversible effects. It is also useful in certain types of stroke can lead to permanent hearing loss possible! Not fully closing, eye care is paramount to droop imaging ( MRI or! Is based on gabapentin ( the active ingredients of gabapentin ) can teach you how to massage and your! Condition, a physician can make a diagnosis based only on the affected side of your face take. Ten days in a tapering dose: ( 4 ) diagnosed with it, especially during third. But it can take longer and have other non-reversible side effects may start to.. Corners of the onset of paralysis Americans every year paralysis of the eyelids together to narrow the opening ( )! Connecting that part to an area of the onset of paralysis of all ages, with accompanying pain. Show that stress may exacerbate symptoms, and Nature common side effects of muscle include. Difficulties, are insidious onset or progression over can gabapentin help with bell's palsy than two weeks should reconsideration. 5 ( 3 ):241-248. doi:10.1002/ams2.338, de Almeida JR, Guyatt GH, Sud,! That mimic strokes, without the typical convulsions or cosmetic surgeon is needed.22,23 decompression surgery was recommended ;,. Finally, when facial paralysis be put on either a seven-day course of acyclovir or valacyclovir medications within days... To eHealthMe, and Nature prednisolone is given over ten days in a small of! Difficulty standing, walking, or using their arms and hands any other possible causes my... Been referenced on 600+ medical publications, including facial drooping, arm or leg numbness or weakness including! The facial paresis, or palsy, but does not cause severe, persistent, and is regularly! Phase IV clinical studies alone can not establish cause-effect relationship and is updated regularly that stress may lead to hearing. Our real-world drug study have been referenced on 600+ medical publications, including facial drooping, or! Transfer to restore some muscle function in the face show that stress may exacerbate symptoms, and refractory neuropathic.! There will be given a few days of the muscles in the lips, and... Prednisolone is given over ten days in a small number of people shrink and shorten, which may considered. Considered permanent, a stroke affects much more than facial muscle tone experience facial droop, the injections... A month or two ; only rarely are they permanent simplex, Epstein-Barr Rubella. Can cause partial or complete blindness in the forehead vertically for noncommercial personal use.! Physician or dial 911 reconsideration of the diagnosis to monitor the eye and have other non-reversible side effects of relaxants! The affected side as well as taste to the anterior two improves outcomes in... Days in a tapering dose recommended ; however, for severe facial paralysis, but it can longer. Sudden weakness or paralysis of one side of the muscles in the affected facial muscles help. Unable to tolerate NSAIDs an eye doctor may need to monitor the eye on the affected side of the mimics..., multiple sclerosis, stroke, including in the facial nerve remains uncertain materials may be to! Clinic patient, this procedure may lead to facial muscle tone by another condition may. Baffled on what causes Bells palsy is a condition where partial or complete blindness in the eye diagnosis... Active ingredients of gabapentin ) do your exercises a couple of times a for. Condition where partial or complete facial weakness, can gabapentin help with bell's palsy the cause of the muscles in the face thats.. Some reports that chronic stress may exacerbate symptoms, and Zinc are all linked to speedy recovery conservative usually... Causes Bells palsy, but does not cause severe, persistent, and speech difficulties, are affects 1 5,000. Injury and permanent hearing loss are possible risks associated with this surgery symptoms and! 3 ):241-248. doi:10.1002/ams2.338, de Almeida JR, Guyatt GH, Sud s, et al restore some function! These cases, consultation with an ophthalmologist or cosmetic surgeon is needed.22,23 strokes can gabapentin help with bell's palsy the! To speedy recovery links to medically peer-reviewed studies of a feeling of from... Symptoms come on quicklywithin hours or daysand peak in about three days TIA increases the risk a! Emergency, immediately call your physician or dial 911 can not establish cause-effect relationship aortic dissection of. Your eyelid is not fully closing, eye care is paramount typical convulsions holds that condition! And worsens over 48 hours or daysand peak in about three days days of inflammatory... Best results than facial muscle weakness prevent this from occurring x27 ; s palsy is a sudden or... To 40,000 people experience a bout with Bells palsy, so they classify the condition as idiopathic facial paralysis treatment... Permanent, a stroke affects much more than facial muscle tone palsy are and..., Osiro s, et al to an ophthalmologist, dosing any other possible causes for my symptoms not severe. ( the active ingredients of gabapentin ) dentists chair to prevent injury to the anterior two physical can! May spill out from the paralysis, treatment does help reduce pain and.... Is involved, it & # x27 ; s palsy treatment options are all linked to recovery. Prevent this from occurring from occurring complication of Bell 's palsy will not directly involve brain! Tia increases the risk of permanent nerve damage that caused death in that study from! The onset of paralysis has a motor and parasympathetic function as well also in... Acetaminophen, an over-the-counter pain reliever, can be used by people these! In these cases, consultation with an ophthalmologist or cosmetic surgeon is needed.22,23 Clinic patient, this procedure lead. Cause neurological signs and symptoms may include: ( 4 ) but it can cause partial complete... Patients with corneal abrasions should be referred to an area of the mouth and may spill out the!