Free Essay

Bell's Palsy

In:

Submitted By naoji
Words 597
Pages 3
Bell’s Palsy

* Sir Charles Bell first described the anatomy and function of the facial nerve in the 1800s. * Bells Palsy describes the sudden paralysis of the facial (VIIth) cranial nerve which renders the patient unable to control the facial muscles on the affected side. * Also called the facial paralysis, is a disorder of the 7th cranial (facial) nerve, characterized by unilateral paralysis of the muscles * The aetiology is unclear although for some cases the presumed pathophysiology of Bells Palsy is due to inflammation from a viral infection. * It may recur on the same or opposite side of the face, and can be transient and permanent. * This disorder can occur at any ages but most often in adults between 20 and 60. * The incidence is equal in men and women. * 80% of clients recover completely within a few weeks to a few months (3/4 recover without treatment). * 15% recover some function but have permanent facial paralysis.

POSSIBLE CAUSES

* Blockage of the seventh cranial nerve (Facial) * Infection from herpes simplex virus * Meningitis * Compression of the nerve by a tumor * Haemorrhage * Trauma to the facial nerve

RISK FACTORS

* Pregnancy increases the risk threefold – mainly seen in third trimester to first week post partum * Diabetes * Viruses: Herpes Simplex Virus and Herpes Zoster Virus

Sensory
Loss of taste

SYMPTOMS

* Sudden onset (over hours) unilateral lower motor neurone facial paralysis – be concerned if onset greater than three * Possible loss of taste over anterior 2/3 of tongue, cannot control salivation on the affected side and inability to make tears * Somatic motor
Facial paralysis
Unable to: * Raise eyebrow and wrinkle brow * Close eye * Drooping of mouth * Blow out cheeks * Whistle

Possible ear pain and hyperacusis

SIGNS

* Unable to raise affected eyebrow and wrinkle brow. * Paralysis on the upper eyelid with loss of the corneal reflex on the affected side. * Difficulty closing eye * If the patient is asked to close their eye and show their teeth the eye ball rotates upwards and outwards: Bell’s Phenomenon * Decreased tear production * Mouth sag on affected side * Unable to blow out cheeks * Unable to whistle * Hyperacusis if the lesion of the facial nerve extends above the point where the branch of the stapedius muscle is given off.

DIAGNOSIS AND TREATMENT

* Blood test * CT scan * MRI

TREATMENT

• PO PREDNISOLONE 60mg od for 10 day then tapering course-aim to start within 72 hours.
• Eye protection if unable to fully close eye: anti-viral treatments

NURSING DIAGNOSIS

* Acute pain * Disturbed sensory perception * Disturbed body image

NURSING INTERVANTIONS

* Use artificial tears four times a day to lubricate the eye; wear an eye patch or tape the eye shut at night. Wear sunglasses when outside, when working on dusty conditions and when using any type of spray. * Apply moist heat to the affected side of the face, taking care not to burn the skin to reduce pain. * Massage the client’s face with a gentle upward motion two to three times daily for 5 to 10 minutes. * Arrange for privacy at mealtimes to reduce embarrassment * A soft diet that does not require chewing and six small meals a day are helpful. Chew slowly on the unaffected side ad avoid hot foods. * Oral care: Clear the mouth and carefully inspect the area between the gums and cheek for food after each meal. * As function returns, practice wrinkling the forehead, closing the eyes, blowing air out of the puckered mouth, and whistling for 5 minutes three or four times a day.

PATHOPHYSIOLOGY

Traumatic injury
Presence of a tumor
Viral infection

Blockage of the 7th cranial nerve

Parasympathetic
Uncontrollable salivation
Decreased tear production

Similar Documents

Premium Essay

Essay On Bell's Palsy

...Bell’s palsy is the paralysis of the muscles usually occurring on one side of the face (although it can happen on both sides of the face). It occurs when the 7th cranial nerve that connects to the muscles of the face fails to function properly, causing the facial muscles to weaken or become paralyzed. The main cause of Bell’s palsy is unknown, but it may caused by autoimmune disorders or viral infections. The believed causes of this disease are herpes simplex virus and shingles. Other viral diseases that can lead to the disease are cytomegalo virus, herpes coxsackievirus, rubella, mumps, and mononucleosis. In the event that there is irritation around the facial nerves, it can press the nerves causing them to completely or partially working. At the point when the nerves quit working, the muscles related with them additionally quit working. Thus, the facial muscles become harmed or numb incidentally until...

Words: 451 - Pages: 2

Premium Essay

Bell's Palsy Essay

...Bell’s Palsy is named for Sir Charles Bell, a 19th century Scottish surgeon and physiologist who described the facial nerve and its connection to the condition. The disorder, which is not related to a stroke, is the most common cause of facial paralysis. Generally, Bell’s Palsy affects only one of the paired facial nerves and one side of the face, however, in rare cases it can affect both sides. (NIND,2003) It’s sudden onset, the cause is unknown but is presumed to involve swelling of the seventh (facial) nerve due to immune or viral disease resulting at the point where it leaves the bony tissue. (Davis, 1985) Due to the inflammation that is directed by the body’s immune system against the nerve controlling movement of the face. This causes...

Words: 741 - Pages: 3

Free Essay

Bell's Palsy

...“Ang gampanin at tungkulin ng isang Physical Therapist sa paggagamot ng may karamdamang Bell’s Palsy” Kabanata I. A. Panimula Ang Bell’s Palsy ay isang“idiopathic facial paralysis” o pansamantalang pagkaparalisa at panghihina ng kalamnan ng isang bahagi ng mukha kaya ito tumatabingi. Partikular na tinatamaan at namamaga ang cranial nerve VII (facial nerve), na sumusuporta sa mga kalamnan ng mukha.Ang katawagang bell’s palsy ay hango sa Scottish anatomist na si Charles Bell. “Bell’s palsy is the most common acute mononeuropathy (disease involving only one nerve) and is the most common cause of acute facial nerve paralysis,” paliwanag nito. Ang kaso ng Bell’s Palsy ay umaabot ng 15-30 kada 100,000 tao kada taon.Ang karaniwang inaatake ay ang mga buntis at mga taong diabetic, ayon sa pagsusuri ng American Academy Neurology(AAN). Ang mga batang may taong 13 pababa ay mas mababa ang posibillidad ng pagatake nito. Itinuturong dahilan kaya nagkakaroon ng Bell’s Palsy ay ang pamamaga ng facial nerve dahil sa injury o infection Napagalaman din na ang virus na karaniwang umaatake ay ang Herpes sipmplex virus(HSV-1). Dahilan din ang disorder sa immune system. Hindi lamang ang pagka-paralysis ng facial muscles ang maaaring maranasan ng may Bell’s Palsy kundi maaa-ring makadama siya ng sakit sa likod ng taynga, kawalan ng panglasa sa pagkain at maaari rin na hindi makarinig. Iglap ang pagkaparalisa ng facial muscles kaya hindi mapigilan ang pagkurap, pagkisap at ang paggalaw...

Words: 5999 - Pages: 24

Free Essay

Bells Palsy

...Bells Palsy Bell’s palsy is a condition that causes the facial muscles to weaken or become paralyzed. It's caused by trauma to the seventh cranial nerve, and is not permanent (There have been cases where the patient has not recovered). Bell's Palsy is not as uncommon as one might think. Worldwide statistics set the frequency at just over .02% of the population. Statistically this is one of every 5000 people over the course of a lifetime and 40,000 Americans every year [1]. Diabetics are more than four times more likely to develop Bell's palsy than the general population and the last trimester of pregnancy is considered to be a time of increased risk for Bell's palsy [2]. In 2004 I was diagnosed with Bells Palsy and it was at this point I decided that I needed to do all necessary research to make sure I would make a full recovery. Soon after diagnosis I learned that a number of factors not limited to but including; Herpes Simplex One, stress, insufficient sleep, upper respiratory infections, Rubella, Mumps, and Lyme disease could potentially cause Bells Palsy. Treatment usually consists of a physician prescribing an antiviral or steroid medication as this is thought to speed up recovery time. Symptoms usually last for less than 3 months but can last longer in extreme cases. In addition to antiviral or steroidal medication, there are alternate treatment options for someone looking to make as full a recovery as possible. One treatment, although controversial is acupuncture...

Words: 407 - Pages: 2

Free Essay

Bells Palsy

...Bell's palsy is a form of facial paralysis resulting from a dysfunction of the cranial nerve VII (the facial nerve) causing an inability to control facial muscles on the affected side. Often the eye in the affected side cannot be closed. The eye must be protected from drying up, or the cornea may be permanently damaged, resulting in impaired vision. In some cases denture wearers experience some discomfort. The common presentation of this condition is a rapid onset of partial or complete paralysis that often occurs overnight. In rare cases, it can occur on both sides resulting in total facial paralysis. Bell’s palsy is defined as a one-sided facial nerve paralysis of unknown cause. Several other conditions can also cause facial paralysis, e.g., brain tumor, stroke, myasthenia gravis, and Lyme disease; however, if no specific cause can be identified, the condition is known as Bell's palsy. It is thought that an inflammatory condition leads to swelling of the facial nerve. The nerve travels through the skull in a narrow bone canal beneath the ear. Nerve swelling and compression in the narrow bone canal are thought to lead to nerve inhibition or damage. Usually it gets better on its own with most people achieving normal or near-normal function. Corticosteroids have been found to improve outcomes, when used early, while anti-viral drugs have not.[3][4] Many show signs of improvement as early as 10 days after the onset, even without treatment. Bell's palsy is the most common acute...

Words: 735 - Pages: 3

Free Essay

Bells Palsy

...Rationale I have selected Bell’s palsy as a minor health subject for critical analysis for three principal reasons. Firstly, it is the most common disorder affecting the facial nerves (Ardour, 1978). Secondly, research has noted that there appears little consensus in the literature regarding the causes and management of Bell’s palsy. Additionally the diagnosis is one of elimination. Tiemstra and Khatkhate (2007) demonstrate there are many other conditions which can mimic symptoms (See appendix one). I therefore wanted to analyse the available literature in order to be able to competently and safely recognise the condition in the urgent unscheduled care environment. Background Petruzelli (1991) states that Bell’s palsy is an acute paralysis of the facial nerve first described by the Scottish surgeon and anatomist, Sir Charles Bell . Niparko (1993) elaborates that it is a generally unilateral paralysis or weakness of facial musculature consistent with facial nerve damage and dysfunction. The anatomy of the facial nerve can be found in appendix two. Pietersen (2002) states that the cause is unknown, however, whilst the exact aetiology of Bell’s palsy is still debated, viral infections, vascular ischaemia, autoimmune inflammatory disorders and heredity have been postulated as causative. (Adour 1982, Burgess 1984, Lorber 1996). Murakami et al (1996) proposed that reactivation of herpes simplex virus in the geniculate ganglia was causative. A herpes simplex cause is corroborated...

Words: 3268 - Pages: 14

Free Essay

Real Estate Designs

...Research Document Requested By:Not On Request Date Requested: Assigned To: Date Assigned: Status: Published Date Completed: 01/07/97 Title: Bell's Palsy General Summary Author: Nancy J. Austin Topic: Nervous System Subject:Bell's Palsy Synonyms/Keywords: Facial nerve palsy Refrigeration palsy Facial paralysis Idiopathic Facial Palsy Antoni's Palsy Facial palsy Introduction: Bell's Palsy is a form of facial paralysis resulting from a facial nerve disorder. Paralysis is nonprogressive and results from decreased blood supply, compression or inflammation of the 7th (facial) cranial nerve. The majority of cases of Bell's Palsy are temporary and symptoms usually subside within two weeks; about 80% of patients recover completely with three months. Only in rare cases are symptoms permanent. Symptoms One sided facial paralysis Inability to close one eye Facial pain Tearing Drooling Hypersensitivity to sound Impairment of taste Headache Lower facial weakness Associated diseases Acoustic Neuroma, a benign tumor of the 8th cranial nerve, produces symptoms that are similar to Bell's Palsy. Growth of the tumor may lead to numbness in the mouth, slurred speech and hoarseness. Myasthenia Gravis is a neuromuscular disease characterized by muscle weakness, affecting the mouth, lips, tongue and voice box. The patient may experience difficulties in speaking, chewing, and/or swallowing. Additional symptoms are drooping eyelids and double...

Words: 582 - Pages: 3

Premium Essay

Bell Palsy Research Paper

...Bell palsy What is Bell palsy? Bell palsy is a neurologic disorder characterized by dysfunction of cranial nerve VII, the facial nerve. Individuals typically develop one sided facial weakness that may be associated with altered saliva and tear production on the same side as facial weakness. Individuals may also experience loss of sensation in the anterior two-thirds of the tongue. Most individuals experience a full recovery, however, a subset of patients have permanent facial weakness. This may lead to psychological symptoms and disability. Eye lid involvement can result in the inability to close the eyelid. Individuals often require frequent use of eye lubricants and referral an eye specialist. Lower facial muscle involvement can lead to drooping of the corner of the mouth and slurred speech (dysarthria). These symptoms are often mistaken...

Words: 1224 - Pages: 5

Premium Essay

Personal Narrative: Bell's Palsy

...When I was in the seventh grade I woke up one morning and the right side of my face was completely paralyzed. I could not blink, raise my eyebrow, or fully smile. The right side of my face would droop down, my eye would become dry because I could no longer blink, and I could no longer taste anything that I ate. I was diagnosed with having Bell’s Palsy and the only treatment was that it would get better on its own over time. So for 8 weeks I walked around with a droopy face, having to blink my eye manually, and went to sleep with an eye patch on in order to prevent my eye from drying out. I was extremely scared not only because I thought I would be paralyzed for the rest of my life but also because I was afraid that kids at school would laugh...

Words: 622 - Pages: 3

Free Essay

Cerebral Palsy

...CEREBRAL PALSY Presented to Cerebral Palsy is defined as an abnormal development or damage affecting the motor centers of the brain, accompanied by neurological and physical abnormalities. According to CDC, Cerebral Palsy is the most common motor disability found in children. It affects movement, posture, and balance. In the majority of cases children are diagnosed with Cerebral Palsy by the age of three. Statistics show that on average every two to three children in one thousand fall victim to this disorder. The combined total of all children and adults in the United States living with Cerebral Palsy is estimated to be around 800,000. Symptoms vary from child to child as well as the age of onset. Some signs to look for are any disturbances in the development of learning. Such as if the child is having trouble learning to crawl, walk, rolling from side to side, or sitting by the appropriate age that developmental milestones should be achieved. If the child is only using one hand to grab things while keeping the other hand balled up into a fist. Another common behavior to look for is the child dragging one entire side of the body while trying to crawl with the use of only the opposite side. More causes for concern would be stiff muscles, exaggerated muscle reflexes, muscles not stiff enough resembling a flopping of the limbs, and difficulty with speech and eating. The website Cerebral Palsy Help http://cerebralpalsyhelp...

Words: 807 - Pages: 4

Free Essay

Cerebral Palsy

...INTRODUCTION While cerebral palsy is a blanket term commonly referred to as “CP” and described by loss or impairment of motor function, cerebral palsy is actually caused by brain damage. The brain damage is caused by brain injury or abnormal development of the brain that occurs while a child’s brain is still developing — before birth, during birth, or immediately after birth. Cerebral palsy affects body movement, muscle control, muscle coordination, muscle tone, reflex, posture and balance. It can also impact fine motor skills, gross motor skills and oral motor functioning. Those with cerebral palsy were most likely born with the condition; although some acquire it later. It was once thought that cerebral palsy was caused by complications during the birthing process. While this does happen, it is now widely agreed that birthing complications account for only a small percentage, an estimated ten percent, of cerebral palsy cases. In my interview with Mrs. Rachel Kagichiri, a parent to a recently diseased CP child, she explained to me that many of the misconceptions we have about the disease should be done away with. Karanja, her son, was often blamed on her ‘negligence’ by relatives and friends who openly thought she must have done something for her son to turn out this way. Current research suggests the majority of cerebral palsy cases result from abnormal brain development or brain injury prior to birth or during labor and delivery. Accidents, abuse, medical malpractice...

Words: 2792 - Pages: 12

Premium Essay

Right Spastic Hemiparesis Case Study

...Right spastic hemiparesis-chronic: paralysis of one side of the body usually resulting from damage to the corticospinal tracts of the central nervous system. Most common cause of hemiplegia is a stroke cause by thrombosis brain hemorrhage or cerebral embolism Patient is unable to perform normal daily hygiene requirements, ranging from bathing, eating, oral care, medication administration, dressing, cleaning due to Right spastic hemiparesis (chronic). Patient does not have control over muscles (LeMone, 2015, p.1403). Improper positioning and support to minimize tissue pressure should be provided for all patients, including those with pressure ulcers. The development of any new ulcers should prompt review of the method and intensity of preventive...

Words: 272 - Pages: 2

Premium Essay

Annotated Bibliography Essay

...Bibliography Alagesan, J., & Shetty, A. (2011). Effect of Modified Suit Therapy in Spastic Diplegic Cerebral Palsy - A Single Blinded Randomized Controlled Trial. This source gives background information about suit therapy and how it is an effective intervention for children with cerebral palsy. Alagesan and Shetty’s article focuses on how this alternative therapy is used to improve gross motor movement in children who have cerebral palsy. In the study, thirty randomly chosen children, ages four to twelve years old, were chosen to study the effects suit therapy has on gross motor movement. Gross motor function was measured before and after the intervention, demonstrating the results suit therapy can have on children who have cerebral palsy. The study concluded that suit therapy, when combined with other therapies, is an effective intervention for spastic diplegic cerebral palsy. This source is credible because it was published in the Online Journal of Health and Allied Sciences. This means it was peer-reviewed, which makes it credible....

Words: 1711 - Pages: 7

Premium Essay

Cerebral Palsy Essay

...The purpose of this essay is to evaluate the role of casting and it’s effectiveness in the management of lower limb contractures for children with cerebral palsy. ‘Cerebral palsy describes a group of permanent disorders of the development of movement and posture, causing activity limitation that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain. The motor disorders of CP are often accompanied by disturbances of sensation, perception, cognition, communication, and behaviour by epilepsy, and by secondary musculoskeletal problems.’ (Rosenbaum et al 2007). Upper motor neuron lesions lead to the impairment of voluntary muscle function and development of increased tone or spasticity in the affected...

Words: 1405 - Pages: 6

Premium Essay

Cerebral Palsy

...Cerebral palsy is impaired muscle caused by brain damage usually before, birth or after birth. Cerebral palsy affects young children the most. The injury occurs within the brain development that occurs through utero or soon after birth. The cerebral palsy affects the motor neuron and sensory neurons. Cerebral palsy has no cure for the damage that has been done to the brain. Cerebral palsy was considered a movement disorder associated with white matter injury. White matter is the brain and spinal cord which contains myelin sheath. Cerebral palsy affects the neurons, such as the grey matter which has the abnormalities in the cortex and subcortical structures which contribute to developmental delay (Balakrishnan, B., Nance, E., Johnston, M. V.,...

Words: 617 - Pages: 3