Bell's palsy

Question 1

Define Bell’s palsy?

Answer 1

It is an acute lower motor neurone disorder

Question 2

What is associated with/what causes it?

Answer 2

It is associated with viral infections and facial nerve swelling in the facial canal but in most cases cause is not known.

Question 3

Which infection is mostly associated with Bell’s palsy?And what are patients required to get?

Answer 3

1.HIV infection
2.Screening HIV test

Question 4

How does Bell’s palsy present?

Answer 4

As a painless loss of power on one side of the face.

Question 5

What are the functions of the facial nerve?

Answer 5

1.Motor innervation of the facial muscles.
2.Parasympathetic innervation to the lacrimal gland and mucous glands of the nasal cavity,maxillary sinus and palate
3.Nerve to the stapedius
4.Sensory innervation of the anterior two thirds of the tongue.

Question 6

Symptoms of Bell’s palsy?

Answer 6

1.Loss of wrinkling of the forehead
2.Inabilitiy to close eyes
3.Drooping of corner of eye
4.Loss of nasolabial fold
5.Drooping of the mouth

Question 7

Describe the difference between a LMN and UMN lesion of the facial nerve

Answer 7

REFER TO HANDOUT

Question 8

Describe the management of Bell’s palsy

Answer 8

If the patients is seen within 48hrs to 72hrs -
Steroids(Prednisolone) and Antivirals(Aciclovir)

For prevention of corneal damage:
1.Eye patch,Eye drops,glasses with side protection
2.In severe cases a temporary tarsorrhaphy may be needed

Physiotherapy with facial exercises

Question 9

What differentiates a LMN from a UMN?

Answer 9

Wrinkling of the forehead.