The plane had just reached cruising altitude when the hostesses asked the passengers if there was a doctor on board. Fortunately there was one, to the relief of the crew, since they believed that one of the passengers was suffering a stroke, a sudden and dangerous blockage of blood It flows to the brain, which can cause brain damage and sometimes death.
But the doctor and professor of medicine Alan J. Hunter He ran into strange and severe symptoms very different from a stroke. "When I approached the passenger, I saw that he was young and fit, with a complete facial fall on the right side"the doctor wrote in the case report recently published in the 'Annals of Internal Medicine'." In addition to the facial fall, he had lost the wrinkles on his forehead and could not close his right eye, "he adds.
The passenger explained that several minutes earlier, during the ascent of the plane, he had experienced a sudden headache on the right side of the head, accompanied by an earache and a feeling of pressure. Despite the difficulty for talk and be drooling, the young man was mentally alert and could articulate phrases, showing normal physical strength and coordination. He explained to Hunter that he had no medical conditions, but that he had recovered from a cold the day before.
If the man had suffered a stroke, the plane would have had to land as soon as possible so that the passenger could receive urgent medical attention. But the symptoms apparently a form of facial paralysis called Bell's palsy, whose causes are often unclear, they did not need to land, Hunter concluded.
Whatever triggered this rapid-onset facial paralysis, it was not a stroke, Hunter thought, but another fact: something most likely related to the flight, and specifically, the moment of takeoff, which was when the symptoms began. "I I focused on the moment the condition occurred, which occurred during the ascent, and in the resolution of the upper respiratory tract infection of the patient, "explains Hunter.
Despite his difficulty speaking, the young man was mentally alert and could articulate sentences, showing physical strength and coordination
The first thing the specialist asked himself was "if the decrease in atmospheric pressure could having meant an increase in ear pressure middle, in the eustachian tube, blocking transmission to the branches of the seventh nerve. "
The passenger was given oxygen-enriched air and was asked to try to relieve the pressure in his ears, using methods such as yawning, swallowing and the Valsalva maneuver. After 15 minutes, he said he felt better and his ear block was gone; A few minutes after that, all his symptoms seemed to have resolved.
The paralysis of the plane
After landing, Hunter investigated the strange symptoms that man experienced and discovered that there were precursors in the medical literature, including a documented case of "airplane paralysis" described in a 2018 report.
"I identified several cases described as facial barotrauma," the doctor explained. However, more frequently, problems arise in circumstances related to diving. "The condition occurs during the ascent of the divers and infrequently on a flight, during the high altitude overland travel, after certain operations in the middle ear," he added.
According to Hunter, the facial barotrauma it can happen when the atmospheric pressure decreases, as happens in the cabin of an airplane during takeoff. When this happens, the pressure in the middle ear increases, which leads to what is called ischemic facial nerve dysfunction (also known as neurapraxia).
Facial barotrauma can occur when atmospheric pressure decreases, as happens in the cabin of an airplane during takeoff
While the symptoms are severe and can be distressing, not only because they resemble some of the telltale signs of an acute stroke, the good news is that unilateral facial paralysis such as this is only temporary and It can be solved with 15-30 minutes of exercises to relieve middle ear pressure and breathe oxygen enriched air.
"In most of cases this situation is limited in time, it is rarely persistent or recurrent, "Hunter said." Prophylactic antihistamines, decongestants or corticosteroids can reduce edema and mucosal secretions and prevent recurrent episodes, "he concluded.