Bioethics Blogs

Facial Paralysis: Somaticizing Frustration in Guatemala by Nicholas Copeland

While conducting ethnographic fieldwork on indigenous political organizing in northwest Guatemala in the mid 2000s, I encountered, quite by accident, an apparent epidemic of Bell’s Palsy—an illness involving the paralysis of one half of the face, known locally as derrame facial (facial stroke) or parálisis facial. After conversing with sufferers, I began to wonder what their condition and the prevalence of cases might reveal about how marginalized Guatemalans experienced social life after decades of injustice and reactionary violence in the midst of a failing democratic transition.

US clinicians define Bell’s Palsy as a temporary paralysis of one side of the face caused by trauma to the seventh cranial nerve.[1] Researchers in Minnesota found that the condition affected 20-30 in 100,000 people.[2] Although there are few identified risk factors, pregnancy and advancing age are understood to play predisposing roles. Central to the dominant US medical model of facial paralysis is a bodily trauma that causes the cranial nerve to swell against the narrow and bony fallopian canal, affecting all functions associated with the seventh nerve: muscular movement of the neck, forehead, and face (including its expressions); secretions of the lower jaw; tear duct and salivary gland expression; taste; and outer ear sensation. Although the exact cause is often undiagnosed the types of injury commonly understood to produce Bell’s palsy include wounds, blunt force, broken bones in the face, injuries to the brain stem, tumors—specifically acoustic neuroma—and cysts, as well as infection and autoimmune disorders. The lower halves of the faces of those afflicted with Bell’s palsy are usually swollen and one side of their mouth droops down, as if they were smoking an invisible pipe.

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