...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...
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...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...
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...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...
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...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...
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...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...
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...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...
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...Practice INTODUCTION: I am going to talk about Cerebral Palsy which is a nervous system disorder. In this disorder clients have dysarthria, a speech impediment, that makes it difficult for them to communicate. In nervous system the ability to communicate may be impaired by factors that include: * Damage to the speech centres in the brain, * Damage to the temporal lobes, which hinders the perception and interpretation of stimuli, * Damage to the cranial nerves responsible for movement of the lips, tongue, pharynx and larynx, * Limited motor function that hinders non-verbal communication gestures, * Visual or hearing deficits, * Altered levels of consciousness or mental status. ( Maureen farrell et al:(2005) Australia, Medical Surgical Nursing “Neurological Function” (see pp1896-1910), * Funnel, koutoukidis, et al:(2005) Australian, “Neurological Health” (see chapter 43, pg745). CEREBRAL PALSY: Cerebral Palsy comprises a group of neuromotor disorders resulting from prenatal, perinatal or postnatal cerebral hypoxia or damage. Thesedisorders is highest in premature infants or in infants who have experienced a difficulty birth resulting in cerebral damage. There are three common types of cerebral Palsy, although some individual may have symptoms of more than one type. The three types of cerebral palsy are spastic, athetoid or dyskinetic, and ataxic. CEREBRAL PALSY IN ADULTS: Children with special needs grow into adults...
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...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...
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...is presumed to have some reinforcing function 2. Acquired disorders: due to an injury. 3. Akathesia: A syndrome characterized by an inability to remain seated, with motor restlessness and a feeling of muscular quivering; may appear as a side effect of antipsychotic and neuroleptic medication. 4. Asymmetric tonic neck reflex (ATNR): A primitive reflex, also called fencer’s response, found in infants, usually is no longer evident by 3 months of age. When neck is turned in one direction, the arm shoots out on the same side and flexes on the opposite side; similar changes occur in the legs. 5. Athetoid diplegia: A form of cerebral palsy primarily seen where there is no muscle control in which the legs are more affected than the arms. 6. Athetoid hemiplegia: A form of cerebral palsy which is a form of dyskinetic cerebral palsy associated with athetosis (constant random, writhing involuntary movements of the limbs. One side of the body is more affected than the other; usually, the arm is more affected than the leg. Because the motor neurons that control one side of the body are located in the opposite cerebral cortex, a right-side hemiplegia implies damage to or dysfunction of the left side of the brain, and vice versa. 7. Autonomy: Self-determination. 8. Beneficence: obligation to act to help the individual. 9. Binet and Simon: Mental testing movement. 10. Bootleg reinforcement: The reinforcement that an individual receives (usually attention from...
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...Being the new girl Today is my first day at the junior high My first class is social studies Mrs. Rein. When I walk in she hands me a paper and says chair number 12 as she rolls her eyes and walks away. I hurry up and grab my chair as soon I get to sit down BAM I fall straight on my butt …….moment of silence then all of a sudden a burst of laughter I get up and the teacher says are you ok I said yes and she says good now don’t let it happen again. I sit down and immediately put my head down and waited to the bell rang I got up threw my paper on Mrs. Rein’s desk and dash out the room. I stayed in the bathroom until it was time to go. The whole bus ride home I thought, about what happened. As I came through the door my mom gave me a wet kiss and asked me how was my day I wiped her kiss away rolled my eyes and stormed to my room my mom came in the room and ask me was I ok. I wiped my eyes and said everything’s great and sat back as she hit me with a pillow and says hey, everything’s going to be just fine I’ll have my new job in just a couple days and maybe if everything’s not good by then you could probably move back with your dad k she got up and said dinner would be done in a hot second I said what are we having she said steak and closed the door. After we ate dinner my mom took us to Milles ice-cream and we picked out a couple of toppings to put on our ice-cream my mom just got the usual blue berry frozen yogurt my brother got a peanut-butter swirl crunch cone with sprinkles...
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...10 compositions preformed with an intermission in between. Some major compositions that were preformed included the hit songs “call me maybe” and “counting stars”. I was quite surprised when I initially saw the program and the songs listed, because it was hard for me to comprehend how a group with bells could produce songs that we are so accustomed to hearing on the radio. Once the concert got started, I enjoyed seeing how all the bells complimented one another by the different sounds they produced. The concert itself was quite entertaining to me. I was really impressed by how 14-year-old kids could play together and be so professional. Another thing I observed was how some of the members of the ensemble played multiple instruments, which was really impressive. From the start the members of the ensemble tried to get the audience involved in the performance. The director after the first couple of songs introduced the students individually. It was a nice way of getting to know the members of the ensemble on a personal level. It was hard to say any one member of the group stood out from the others because they all worked in sync but the one of the members David played multiple bells at the same time. The audience really seemed to enjoy the music, which was surprising to me. The crowd was older, and I initially thought they would not know many of the...
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...143993 Daniel Olivan EN12 (R70) March 27, 2015 Time Check July 21, 2014. It was another Monday and it was a school day. I woke up early and drove to Ateneo de Manila University where I took up chemistry with materials science engineering. It was my first year in college and the semester just started a month ago, so I was only beginning to get to know the people in my course. On that Monday, my first class was chemistry and good thing that it was only a 50-minute class. I cannot take in all the formulas that Dr. Valera just discussed. My stress level was already too high. It was 8:20 am. My blockmates, Mariel, Diego, and Magin wanted to eat first before their next classes start. They have class at 9:30 while my next one was at 10:30, so we all headed to JSEC which was a cafeteria. After choosing a table, I volunteered to reserve the table and keep guard of their bags while the three of them went to food stalls to order. I checked my phone and it was 8:30 already but still I see no sign of him. Magin was the first one who got back and sat down with his bacon and eggs with fried rice. I expected that he would have mentioned his name, but he didn’t. Instead, he talked about how difficult it was to remember all of the dates in our upcoming history exam next week. I agreed and started asking him what the coverage of the exam was, so that he wouldn’t notice that I wasn’t paying much attention to what he was saying. The truth was I just...
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...study grammar and vocabulary, and create projects that will count as major assignments. Expectations You will be expected to be an integral part of the classroom through active participation in class discussions, activities, and through completion of your assignments. Our class can only be as good as our weakest link. So hopefully you will be a strong contributor to our class and in turn you will learn a lot and have fun in the process. Rules Be Prepared o You come prepared with all materials and homework daily Be Polite Be Prompt o You must be in your seat working when the bell rings or else you will be marked tardy Follow all school rules These rules cover everything and they will be discussed in greater detail on the first day of class. *Remember that the bell does NOT dismiss you. You should not begin packing your belongings until I have dismissed you after the bell. Bathroom Policy You will be given 6 bathroom passes at the start of each six weeks. You may use these at your discretion; however, they should not be used when I am in the middle of a lesson. Wait until we break for individual or group activities. You should go quickly so that you do not miss out on too much instruction. However many unused passes you have at the end of each six weeks will count as extra points...
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...The bell that signaled the end of the day at Woodworth Boys College finally rang. Mark sighed with relief, brushing his long messy hair out of his eyes as he grabbed his books and his bag from his desk. Mark shook his head in annoyance as his hair once again fell onto his dark Pakistani face. His hair was unkempt and dirty, but it's not like his family could afford for him to get a haircut. No, all the money went into getting Mark the best education that his parents could provide. Provided they did, his parents worked overtime, balancing many jobs at once, the fees for Woodsworth College were definitely not cheap. It was by far the best school in Detroit, Mark's home town. He and his parents had lived here since Mark was five, his parents...
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...__________________________________________________________________________________ THE FOURTH DAY "THE GOLDEN OAK LIBRARY" (NON-TARGET) 6:48 AM "Well, maybe the fifth time's a charm?" Twilight teased while scraping Anonymous' previously failed breakfasts into the trashcan. "Cooking has been my mortal enemy for an eternity. Don't worry, I'll should be able to get at least one pancake this time." He said, adjusting the dial for the burner on Twilight's gas stove. Anonymous poured new batter in to the pan and sat it on the burner, adding the ingredients as he cooked. Twilight didn't say anything, she was just staring off into space. Anon looked back to investigate the cause of the silence, giggling when he saw Twi's face. "Have we really run out of things to talk about already?" Anon asked, laughing while doing so. Twilight's blank face snapped to attention. Then immediatly went back to her blank face while she thought. Most of the time they had spent together was in silence, as is they were total strangers. In a way, they were. They had just met yesterday and didn't know that much about each other. "No... It's just..." Twilight tried to explain her train of thought. "Eh, It's alright, don't feel like you're a bad friend." 'Friend' The skeptical antisocial alien called Twilight, The Element of Friendship a friend before she called him one. Now she really didn't feel like a good 'friend'. Judging by Anon's face, he didn't care about it at all. He was too busy reading the instructions...
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