Bell's Palsy

Question 1

What is Bell’s Palsy

Answer 1

Temporary unilateral facial paralysis secondary to trauma with demyelination and/or axonal degeneration of the Ipsilateral Facial Nerve (CN VII)

Question 2

Etiology

Answer 2

Exact etiology is unknown

• Viral infection (herpes simplex/zoster)
• inflammation/edema causing subsequent pressure injures of the facial nerve

Question 3

Signs and Symptoms

Answer 3

Asymmetrical Facial Appearance

• Drooping of the Eyelid and Mouth
• Dryness of the eye
• inability to close the eyelid due to weakness

Question 4

Treatment: Mild Involvement

Answer 4

Mild involvement: symptoms can resolve in about two weeks without formal medical intervention

The sooner a person is diagnosed and treated the better the outcomes

Question 5

Treatment: Greater Severity

Answer 5

Greater Severity:
- antiviral medications
- high dose corticosteroids (usually the first line of treatment)

Question 6

Age range of the highest incidence rates:

Answer 6

Highest incidence in individuals between 15-45 y/o

Question 7

How may a preliminary diagnosis be made?

Answer 7

Functional assessment of facial muscle performance and symmetry with activities:

• smiling
• frowning
• closing the eyes
• baring teeth
• raising the eyebrows

Question 8

PT Management:

Answer 8

• Prevention of long term deficits related to paralysis-related muscle shortening. (PRMS)
• Biofeedback and NMES can assist with targeting specific muscles for strengthening and coordination retraining

Question 9

Outcomes

Answer 9

Generally self-limiting

• Most patients experience spontaneous recovery (within a matter of weeks)
• very severe cases: full recovery, up to 6 months

Question 10

Is Bell’s palsy an UMN or LMN lesion?

Answer 10

LMN Lesion