Facial Paralysis Flashcards
What conditions are associated with facial paralysis?
CVA (brainstem) Bell's Palsy Tumor-Acoustic Nueroma Herpes Simplex Virus Type 1 Trauma Post-surgical complication
How can you tell if the facial paralysis is due to a stroke?
- Can lift eyebrow because frontalis is bilaterally innervated
- Possible sensory loss to face
- Rapid Onset
How can you tell if the facial paralysis is due to bell’s Palsy?
- Cannot lift eyebrow on lesion side…ipsilateral CN VII innervation
- No sensory loss to face…Trigeminal is sensory to face
- Rapid Onset
How can you tell if the facial paralysis is due to a Tumor?
- Tumor compresses nerve
- Might have a mild hearing loss due to the proximity of CN VIII
- Balance may also be impacted due to CN VIII compression
- Slow growing tumor so pts compensate very well. Most times, facial paralysis is the first sign of a tumor
What muscle is important to test for facial paralysis?
Frontalis muscle (test for symmetry and weakness)
What is Bell’s Palsy?
facial muscle weakness due to a lesion or damage to CN VII
What are the signs and symptoms of Bell’s Palsy?
- Weakness of facial muscles
- Inability to lubricate the eye
- Change in taste
- Biting the inside of the mouth
- Drooling
- Poor food management
What should you look for when doing a facial muscle examination?
- weakness
- tightness
- synkinesis
Facial expressions
- raise both eyebrows
- close both eyes tightly
- smile
- puff cheeks
- purse lips
- show upper and lower teeth
What is the prognosis for Bell’s Palsy?
- about 70% of pts with facial paralysis will recover fully
- roughly 18% will have significant dysfunction such as contractures, synkinesis, weakness, or asymmetry
What is synkinesis?
When contracting one muscle voluntary causes other muscles around the area to involuntarily contract
True or False: Facial paralysis, no matter if it is reoccurring, will usually resolve fully in 70% of patients
False, is there is recurrence (5-7% of cases) then there is a poorer prognosis for full recovery
What are the two subscales of the facial disability index? How are they scored?
Physical Function (0-5 scale)
- usually did with
- no difficulty (5)….much difficulty (2) - Usually did not eat because:
- health (1)….of other reasons (0)
Social/Well-being (1-6 scale)
-all of the time (1)….none of the time (6)
Which questions are asked for the Physical Function section of the facial disability index (FDI)?
- How much difficulty did you have keeping food in your mouth, moving food around your mouth, or getting food stuck in your cheek while eating?
- How much difficulty did you have drinking from a cup?
- How much difficulty did you have saying specifci sounds while speaking
- How much difficulty did you have with your eye tearing excessively or becoming dry?
- How much difficulty did you have with brushing your teeth or rinsing your mouth?
What questions are asked for Social Function section of the FDI?
- How much of the time have you felt calm and peaceful?
- How much of the time did you isolate yourself from people around you?
- How much of the time did you get irritable toward those around you?
- How much often did you wake up early or wake up several times during your nighttime sleep?
- How often has your facial function kept you from going out to eat, shop, or participate in family or social activities?
How is the House-Brackmann Classification of Facial Function scale scored?
From Normal (1) to Total Paralysis (6) using both Gross and Motion characteristics
