PRESENTED BY:

SIDRA

TOPIC

BELL’S PALSY

HISTORYHISTORY• Charles Bell

Well known for his studies on the nervous system and the brain.

In the 19th century discovered that lesions of the 7th cranial nerve causes facial paralysis.

Although it is named after Sir Charles Bell.

WHAT IS BELL’S PALSYWHAT IS BELL’S PALSYForm of facial paralysis resulting from a dysfunction

of the cranial nerve VII.

Causing an inability to control facial muscles.

Idiopathic (arising spontaneously), unilateral facial nerve paralysis, usually self-limiting.

In rare cases (<1%), it can occur bilaterally resulting in total facial paralysis.

WHAT CAUSES IT ?

Brain tumor, stroke, myasthenia gravis, and Lyme disease (infectious disease).

The exact reason Bell's palsy occurs isn't clear.

It's often linked to exposure to a viral infection.

Viruses that have been linked to Bell's palsy include the virus that causes:

i. • Chickenpox and shingles (herpes zoster)

ii. • Respiratory illnesses (adenovirus)

iii. • German measles (rubella)

iv. • Mumps (mumps virus)

v. • Flu (influenza B)

vi. • Hand-foot-and-mouth disease.

SIGNS AND SYMPTOMS

A headache or feel pain behind or in front of their ears.

One side of face droops or feels stiff. Others may not be able to move that side of their

face at all. Difficulty closing one eye all the way. Dryness in one eye. Trouble tasting at the front of the tongue. Changes in the amount of saliva or drooling. Hearing sounds that seem louder than usual in one

ear.

RISK FACTORS

Bell's palsy occurs more often in people who:

Are pregnantHave an upper respiratory infection.People who have recurrent attacks of Bell's

palsy.People with diabetes.

TEST AND DIAGNOSIS

• There's no specific test for Bell's palsy.

• Stroke, infections, Lyme disease and tumors can also cause Bell's palsy. If the doctor is still unsure, the patient may be referred to an ENT (ear, nose and throat) specialist. The specialist will examine and may also order the following tests:

Electromyography (EMG) MRI, CT scans or X-rays

TREATMENT AND DRUGS

TREATMENT AND DRUGS

Most people with Bell's palsy recover fully with or without treatment. But your doctor may suggest:

1. Medications

2. Botulinum toxin injections.

3. Physical therapy.

4. Surgery.

MEDICATIONMEDICATION

1. Corticosteroids

Powerful anti-inflammatory agents. Reduce the swelling of the facial nerve.Corticosteroids may work best if they're

started within several days of when your symptoms started.

Example: Prednisone

2. Antiviral drugs

stop the progression of the infection if a virus is known to have caused it.

This treatment may be offered only if your facial paralysis is severe.

Examples: Zovirax and Valtrex.

BOTULINUM TOXIN INJECTION

Botox injected to relax any facial muscles that become tight, or to reduce any unwanted muscle movements.

If muscles in the unaffected side become overactive or dominant, Botox may be injected into this side of the face to reduce muscle activity and balance the movement of the face.

PHYSICAL THERAPY

Paralyzed muscles can shrink and shorten, causing permanent contractures.

A physical therapist can teach you how to massage and exercise your facial muscles to help prevent this from occurring.

SURGERYSURGERY

In the past, decompression surgery was used to relieve the pressure on the facial nerve by opening the bony passage that the nerve passes through.

Facial nerve injury and permanent hearing loss are possible risks associated with this surgery.

COMPLICATIONS

If damage to facial nerve is severe some complications are possible including:

Misdirected re-growth of nerve fibers.Ageusia.Gustatolacrimal reflex.Corneal ulceration.

EXERCISES

While it is a slow process, performing the exercises below may be beneficial:

Curl your upper lip up, and then raise and protrude the upper lip.

Try to smile without showing teeth, then smile showing teeth.

Using your index finger and thumb, pull the corners of your lips in toward the center.

Try to close the eye slowly and gently, without letting your mouth pull up or your eyebrow move downward.

Try to raise your eyebrows, and then hold for 10 -15 seconds. Pause, and repeat.

PROGNOSISPROGNOSIS

Most people begin recovery in 2 to 3 weeks.

70% to 85% of people showing complete recovery in 2 to 3 months.

There is a 10% recurrence rate. Those who are at a higher risk of not getting completely better are often older and those who have a slow recovery from symptoms.

HOME REMIDIESDoing your physical therapy

exercises.

Applying moist heat.

Taking over-the-counter pain relievers.

Protecting the eye you can't close.

ALTERNATE MEDICINE

Relaxation techniques

Relaxing by using techniques such as meditation and yoga may relieve muscle tension and chronic pain.

Biofeedback training

By teaching you to use your thoughts to control your body, you may help gain better control over your facial muscles

Acupuncture

Placing thin needles into specific point in your skin helps stimulate nerves and muscles, which may offer some relief.

CONCLUSION

• It's important to eat well and get lots of sleep when you have Bell's palsy. Good nutrition and rest will help your body as it heals itself.

• Bell's palsy isn't contagious, so no one can catch it from you.