bells palsy

Question 1

task

Answer 1

474

Question 2

>

Answer 2

-acknoledge patients distress
-reassure, it is not a stroke
-occurs due to inflammation and edema which maybe caused by a virus in the temporal bone, which is a narrow canal>this swelling compresses the nerve and causes damage
NATURAL HX
-70 percent recover completely within two months
-20-25%upto six months
-about 10 percent no recovery after one year>higher in older population

Question 3

mx

Answer 3

-high dose steroids 40-80mg 3 days>taper off over the next seven days
-addition of antiviral acyclovir 400 5/day nausea, vomiting diarrhoea
-eye patch, artificial tears
-r/v few days for support
-Ix not necessary>but ct scan as patient is anxious
NEUROLOGY REFERRAL
-for confirmation diagnosis, NCS
-confirmation and mx, because of non recovery or incomplete recovery
FOLLOWUP
-corneal injury, conjunctivitis
-monitor progress
EARLY REFERRAL PHYSIOTHERAPIS
-increase confidence in pt
-nerve stimulation