PowerPoint Presentation

Bells palsy project

Under supervision of PROF.DR\ emam el negamy PROF.DR\ Ibrahim M.Zoheiry

Under the leadership of :Sarah talaat Mohamed Sara abed Salma hassan Safeenaz MohamedSarah ArafatReham mahdy Sharihan magdy Rawan heshamShourouk essamSarah el sayed badawy El shaimaa MohamedAlaa MohamedYoumna MohamedAhmed Mohamed

The nerve that is injured with Bell's Palsy is CN-VII (7th cranial nerve). It originates in an area of the brain stem known as the Pons. The 7th nerve passes through the stylomastoid foramen and enters the parotid gland. It divides into its main branches inside the parotid gland. These branches then further divide into 7000 smaller nerve fibers that reach into the face, neck, salivary glands and the outer ear.The nerve controls the muscles of the neck, the forehead and facial expressions, as well as perceived sound volume. It also stimulates secretions of the lower jaw, the tear glands and the salivary glands in the front of the mouth. Taste sensations at the front 2/3 of the tongue and sensations at the outer ear are transmitted by the 7th nerve.Bells Palsy is caused by an inflammation within a smallbony tube called the fallopian canal. The canal is an extremely narrow area. An inflammation within it is likely to exert pressure on the nerve, compressing it.

Likewise, if the nerve itself becomes inflamed within this small canal, it can encounter pressure, with the same result of compression. The nerve has not yet exited the skull and divided into itsseveral branches, resulting in impairment of ill1functions controlled by the 7th nerve.If only part of the face is affection the condition is not Bell's palsy. If, for example, the mouth area is weak but the forehead moves, Bells palsy is ruled out. Trauma induced by tumor, surgery, etc. can occur at a location where the nerve has already divided into its main branches. This type of trauma may spare one or more branches and allow some muscles to remain functional.

The image at left illustrates the parotid gland area, where the facial nerve divides into its major branches after exiting the skull at the stylomastoid foramen. The major branches then continue to divide into thousands of microscopic nerve fibers.

WHAT IS BELL'S PALSY?Bell's palsy is a condition that causes the facial muscles to weaken orbecome paralyzed. It's caused by trauma to the 7th cranial nerve, and is not permanent.

WHY IS IT CALLED BELL'S PALSY?The condition is named for Sir Charles Bell, a Scottish surgeon who studied the nerve and its innervation of the facial muscles 200 years ago.

IS BELL'S PALSY ALWAYS ON THE SAME SIDE?

Percentage of left or right side cases is approximately equal, and remains equal for recurrences.

IS THERE ANY DIFFERENCE BECAUSE OF GENDER OR RACE?

The incidence of Bells palsy in males and females, as well as in the various races Is also approximately equal. The chances of the condition being mild or severe, and the rate of recovery is also equal.WHAT CONDITIONS CAN INCREASE THE CHANCE OF HAVING BELL'S PALSY?Older people are more likely to be afflicted, but children are not immune to it. Children tend to recover well. Diabetics are more than 4 times more likely to develop Bells palsy than the general population. The last trimester of pregnancy is considered to be a time of increased risk for Bell's palsy.Conditions that compromise the immune system such as HIV or sarcoidosis increase the odds of facial paralysis occurring and recurring.

CAN BELL'S PALSY AFFECT BOTH SIDES OF THE FACE?It is possible to have bilateral Bells palsy, but it's rare, accounting for less than 1%of cases. With bilateral facial palsy, it's important to rule out allother possible diagnoses with thorough ' diagnostic tests.

CAN BELL'S PALSY AFFECT OTHER PARTS OF THE BODY?Bells palsy should not cause any other part of the body to become paralyzed, weak or numb. If any other areas are affected Bell's palsy is not the cause of the symptoms, and further testing must be done.

HOW DO THE SYMPTOMS OF BELL'S PALSY PROGRESS?

Very quickly Most people either wake up to find they have Bells palsy, or have symptoms such as a dry eye or tingling around their lips that progress to classic Bell's palsy during that same day. Occasionally symptoms may take a few days to be recognizable as Bells palsy. The degree of paralysis should peak within sever I day of onset- never in longer than (2)weeks (3)weeks maximum for Ramsey Hunt syndrome). A warning sign may be neck.

EYE RELATED?

Muscle weakness or paralysis Forehead wrinkles disappear Overall droopy appearance Impossible or difficult to blink Nose runsNose is constantly stuffed

Difficulty speakingDifficulty eating and drinking Sensitivity to sound (hyperacusis) Excess or reduced salivationFacial swellingDiminished or distorted taste Pain in or near the ear DroolingEye closure difficult or impossibleLack of tears Excessive tearing Brow droopTears fail to coat cornea Lower eyelid droop Sensitivity to lightADDITIONAL SYMPTOMS WITH RAMSEY HUNT SYNDROME Hearing deficitSevere painLong lasting painVertigo

Symptoms of Bell's palsyThe symptoms of Bell's palsy include:paralysis or weakness on one side of the facenumbnesspain around the ear the eye can't fully closethe mouth droopsthe face feels heavyfoods taste slightly different

Risk factorsBell's palsy occurs more often in people who: Are pregnant, especially during the third trimester, or who are in the first week after giving birth.Have an upper respiratory infection, such as the flu or a coldHave diabetes.

Also, some people who have recurrent attacks of Bell's palsy, which are rare, have a family history of recurrent attacks. In those cases, there may be a genetic predisposition to Bell's palsy.

Complications- Irreversible damage to your facial nerve- Partial or complete blindness of the eye that won't close due to excessive dryness and scratching of the cornea, the clear protective covering of the eye

Diagnosis: Other conditions such as a stroke, infections, Lyme disease and tumors - can also amuse facial muscle weakness, mimicking Bell's palsy. If it's not clear why you're having the symptoms you are, your doctor may ream. mend other tests, including.

Electromyography (EMG).

This test can confirm the presence of nerve damage and determine its severity. An EMG measures the electrical activity of a muscle in response to stimulation and the nature and speed of the conduction of electrical impulses along a nerve.Surgery

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. Today, decompression surgery isn't recommended. Facial nerve injury and permanent hearing loss are possible risks associated with this surgery.In rare cases, plastic surgery may be needed to correct lasting facial nerve problems.