Bell's Palsy Flashcards
What is Bell’s Palsy
Temporary unilateral facial paralysis secondary to trauma with demyelination and/or axonal degeneration of the Ipsilateral Facial Nerve (CN VII)
Etiology
Exact etiology is unknown
- Viral infection (herpes simplex/zoster)
- inflammation/edema causing subsequent pressure injures of the facial nerve
Signs and Symptoms
Asymmetrical Facial Appearance
- Drooping of the Eyelid and Mouth
- Dryness of the eye
- inability to close the eyelid due to weakness
Treatment: Mild Involvement
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
Treatment: Greater Severity
Greater Severity:
- antiviral medications
- high dose corticosteroids (usually the first line of treatment)
Age range of the highest incidence rates:
Highest incidence in individuals between 15-45 y/o
How may a preliminary diagnosis be made?
Functional assessment of facial muscle performance and symmetry with activities:
- smiling
- frowning
- closing the eyes
- baring teeth
- raising the eyebrows
PT Management:
- 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
Outcomes
Generally self-limiting
- Most patients experience spontaneous recovery (within a matter of weeks)
- very severe cases: full recovery, up to 6 months
Is Bell’s palsy an UMN or LMN lesion?
LMN Lesion