Bells Palsy

In: Science

Submitted By Deinah7
Words 693
Pages 3
Hannah Mae Laguros
BELL’S PALSY
Definition: Acute peripheral CN VII (facial nerve) palsy of unknown cause
Aka: prosoplegia, refrigeration palsy, ipsilat. Facial paralysis
Anatomy

* INNERVATIONS 1) Motor: to facial muscles, stapedius, post. digastric, stylohyoid 2) Parasympathetic: to lacrimal, submandibular, sublingual salivary glands 3) Sensory: taste on anterior 2/3 of tongue
Epidemiology
* Annual Incidence 10-40/100,000 * Lifetime incidence 1:60
Cause
* Widely accepted cause is HSV-1, however not proven * HSV mediates inflammatory/immune response which leads to myelin sheath degeneration, & edema which causes compression and further damage of CN VII
Clinical Features 1. Sudden onset symptoms, usually hours w/ maximal weakness w/in 48 hrs 2. Unilateral 3. Eyebrow sagging 4. Inability to close eye 5. Loss of nasolabial fold 6. Decreased tearing 7. Hyperacusis 8. Loss of taste to anterior 2/3 tongue 9. Mouth droop
Evaluation & Diagnosis * Bell’s Palsy is a clinical diagnosis based on * typical presentation * absence of other explanation or other underlying disease * absence of cutaneous lesions * otherwise normal neuro exam * Proceed with imaging (MRI) if * Atypical Presentation * Slowly progressive over 2-3 weeks * If no improvement in symptoms in 6 wks * Electrophysiology (CMAP) performed if complete facial paralysis remains after 1 week of treatment
Treatment
* PT management: modalities, facial exercise, massage * Manual closing of eye such as with tape while sleeping, lubricating eye drops * Steroids * +/-Acyclovir * Surgical Decompression – no good evidence to support
Prognosis
* 80% recover within weeks to months * If motor nerve conduction studies show evidence of…...

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