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Varicella Zoster This viral infection usually has its first manifestation as chicken pox. Then, the virus goes into hiding, sometimes in the geniculate ganglion of the facial nerve. If the virus reactivates, it causes blisters on the affected neurons: the lesions are sometimes called shingles. When the facial nerve is involved, facial paralysis can occur along with the characteristic pain for which shingles is famous. Facial paralysis along with a varicella zoster outbreak is sometimes called Ramsay-Hunt syndrome. Other Viruses Other viruses that can affect the facial nerve include HIV; hepatitis A, B, and C; influenza; Epstein-Barr virus; and cytomegalovirus.3 Viral infections are typically treated with a combination of antiviral drugs (acyclovir, famcyclovir, or valocyclovir), and prednisone—a steroidal anti- inflammatory. If treatment begins within three days of onset of a viral attack, the prognosis for recovery and freedom from complications are good.4 BACTERIAL INFECTIONS The most common bacterial infection associated with facial nerve damage is from the pathogen borrelia Burgdorferi, the spirochete that causes Lyme disease. When facial paralysis is accompanied by a bull's-eye rash, or any swelling and redness of the face, a test for Lyme disease should be conducted. In fact, in parts of the country where Lyme disease is endemic, any person with facial paralysis may be tested, just in case.5 Obviously, facial paralysis due to a bacterial infection won't respond to antiviral medication. This is why it is important to get an accurate diagnosis as quickly as possible so that the correct antibiotics can be used in the hopes of a speedy and uncomplicated recovery. The same mycoplasmas that cause pneumonia may also irritate the facial nerve. OTHER CAUSES The list of other possible sources of irritation to the facial nerve is long, and an accurate diagnosis must rule these out. These differentials can include genetic predisposition, tumors of the salivary glands or other tissues, Guillain-Barré syndrome, multiple sclerosis, sarcoidosis, HIV infection, HTLV-1 infection, and barotrauma (damage to tissues related to diving). Fortunately, most of these conditions have a much slower onset than a typical Bell's palsy case, or they are Myofascial Mobilization Workshop Develop an exciting and lucrative career in helping others by deepening your therapeutic effectiveness. This introductory "hands-on" seminar will introduce the theory of Myofascial Release. Participants will learn Myofascial Mobilization techniques focusing on the upper and lower extremities, cervical, thoracic, and lumbar areas. John F. Barnes, PT, LMT, NCTMB International lecturer, author, and authority on Myofascial Release. NCBTMB APPROVED PROVIDER FOR CONTINUING EDUCATION Myofascial Release Seminars is approved by the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) as a continuing education Approved Provider. #025821-00. • Eau Claire, WI . . . . . . . . . . . . September 12 & 13, 2009 • Hamilton, Ontario . . . . . . . . . . . . October 3 & 4, 2009 • Gainesville, FL . . . . . . . . . . . . . . October 10 & 11, 2009 • Fort Wayne, IN. . . . . . . . . . . . November 14 & 15, 2009 • Greenville, NC . . . . . . . . . . . . . . December 5 & 6, 2009 Register Today— Call 1-800-FASCIAL Visit our Website at MyofascialRelease.com visit massageandbodywork.com to access your digital magazine 101