Bell's Palsy & Acoustic Neuroma

Question 1

Facial Palsy

Answer 1

Idiopathic peripheral facial palsy; cranial mono neurophay

Question 2

what is bell’s palsy

Answer 2

• Disorder of the nerve that control movement of the muscles in the face (facial or 7th cranial nerve)
• damage to this nerve causes weakness or paralysis of these muscles.
  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. Several conditions can cause facial paralysis, e.g., brain tumor, stroke, and Lyme disease. However, if no specific cause can be identified, the condition is known as Bell’s palsy.

Question 3

What is the incidence?

Answer 3

30,000-40,000 annually in the US
- cause is often unclear- some conditions that may cause Bell's Palsy include:
herpes zoster
HIV
Lyme disease
Middle ear infection
Sarcoidosis

Question 4

Symptoms of Bell’s Palsy

Answer 4

• almost always on one side of face only
• can range from mild to severe
• face will feel stiff and pulled to one side
• other symptoms:
• Difficulty closing one eye
• difficulty eating and drinking- food falls out of one side of mouth
• Drooling
• Drooping
• Problems smiling and making facial expressions
• twitching or weakness of the muscles in the face

Question 5

Diagnosis

Answer 5

• take health history and do complete physical exam
• sometimes a brain tumor may cause similar symptoms and if this is the case a CT scan of the head, Magnetic resonance imaging (MRI) of the head will be ordered
  Muslces of the face may also be checked through an EMG or nerve conduction test

Question 6

Prognosis

Answer 6

if all nerve function is not lost and symptoms inprove within 3 weeks people are likely to regain most of the strength in facial muscles
- some symptoms may still be present such as:
- long-term changes in taste
- spasms of muscles or eye lids
- weakness that remains in the facial muscles
potential complications can include excess drying of the the eye surface, leading to eye sore of infection

Question 7

ACOUSTIC NEUROMA

Answer 7

AKA vesticbular schwannomas- non-malignant tumors of the 8th cranial nerve
- Most commonly arise from the schwann cells of the inferior vestibular nerve

• They are relatively rare

Question 8

Cause of acoustic neuroma

Answer 8

occurs in 2 forms

1. sporadic form- 95% of cases
2. form associated with an inherited syndrome called neurofibromatosis type 2 (NF2)

Question 9

symptoms

Answer 9

patient begins to experience symptoms when nerves and brain structures are compressed by the growing mass

• early symptoms include hearing loss, ringing in the ear (tinnitus) and dizziness
• sometimes mild to moderate pain is felt behind and slightly above the ear
• paradoxically, smaller tumors are more prone to produce pain in this location