scholarly journals Rehabilitation of a Patient with Bell’s Palsy

2021 ◽  
Vol 10 (20) ◽  
pp. 1551-1554
Author(s):  
Vrushali K. Athawale ◽  
Dushyant P. Bawiskar ◽  
Pratik Arun Phansopkar

Facial nerve palsy is the disease of cranial nerve. From the total number of cases, 60 to 75 % of Bell's palsy cases are idiopathic form of facial palsy. Facial nerve palsy results in weakness of facial muscles, atrophy, asymmetry of face and also disturbs the quality of life. Bell’s palsy occurs in every class of population affecting people of all the age groups but the most common age group affected is 15 - 50 years with equal sex prediliction accounting 11 - 40 cases per 100,000. If facial palsy is not treated properly then it may result in variety of complications like motor synkinesis, dysarthria, contractures of facial muscles, and crocodile tear. Currently facial paralysis treatment consists of combination of pharmacological therapy, facial neuromuscular re-entrainment physiotherapy or surgical intervention by static and dynamic facial reanimation techniques. Physiotherapy treatment is effective for treating facial paralysis with minimal complications and can be individualized. Bell's palsy is the idiopathic form of facial nerve palsy which accounts for 60 to 75 % of cases and male to female ratio is 1:3.1 The aetiology of facial paralysis is not yet thoroughly understood. Cases of varicella-zoster, mononucleosis, herpes simplex virus, mumps and measles have demonstrated good serology in several reports for their association but still stands unclear. 2 Peripheral facial nerve palsy may be idiopathic (primary cause) or Bell’s palsy (secondary). Causes of the secondary unilateral facial nerve palsy are diabetes, stroke, Hansen's disease, herpes simplex infection, birth injury, trauma, tumour, Guillain-Barre syndrome, and immune system disorders. Causes of the bilateral facial nerve palsy are leukemia, brainstem encephalitis, leprosy, and meningitis. The most prominent current theories of facial nerve paralysis pathophysiology include the reactivation of herpes simplex virus infection (HSV type 1). Current facial paralysis treatment consists of a combination of pharmacological therapy, facial neuromuscular re-entrainment physiotherapy or surgical intervention by dynamic and static facial reanimation techniques.7 This is a diagnosed case of right facial nerve palsy which was treated under physiotherapy department with proper rehabilitation protocol.

1995 ◽  
Vol 104 (7) ◽  
pp. 574-581 ◽  
Author(s):  
Toshiaki Sugita ◽  
Yasuo Fujiwara ◽  
Shingo Murakami ◽  
Yoshinari Hirata ◽  
Naoaki Yanagihara ◽  
...  

We have been the first to succeed in producing an acute and transient facial paralysis simulating Bell's palsy, by inoculating herpes simplex virus into the auricles or tongues of mice. The KOS strain of the virus was injected into the auricle of 104 mice and the anterior two thirds of the tongue in 30 mice. Facial paralysis developed between 6 and 9 days after virus inoculation, continued for 3 to 7 days, and then recovered spontaneously. The animals were painlessly sacrificed between 6 and 20 days after inoculation for histopathologic and immunocytochemical study. Histopathologically, severe nerve swelling, inflammatory cell infiltration, and vacuolar degeneration were manifested in the affected facial nerve and nuclei. Herpes simplex virus antigens were also detected in the facial nerve, geniculate ganglion, and facial nerve nucleus. The pathophysiologic mechanisms of the facial paralysis are discussed in light of the histopathologic findings, in association with the causation of Bell's palsy.


Author(s):  
Gabriel Toye Olajide ◽  
Waheed Atilade Adegbiji ◽  
Akinwale Olaleye Akinbade ◽  
Anthony Oyebanji Olajuyin ◽  
Paul Olowoyo

Background/Aim: Facial nerve palsy may cause facial asymmetry, functional and cosmetic impairment, and therefore imposes great psychological and social problems on the individual with the condition. The aim of this paper was to highlight the aetiological profile of facial nerve palsy (FNP) in two tertiary institutions in Ekiti, southwest, Nigeria. Methods: This was a retrospective review of patients with facial nerve palsy seen and treated at Ear, Nose & Throat (ENT) clinic. All folders and registers of patients diagnosed with facial nerve palsy from January 2010 to December 2019 in the central, ENT and Dental medical records departments were retrieved and reviewed. The information extracted included the socio-demographic characteristics of the patients, clinical presentation, type and aetiology of FNP, side affected, diagnosis/impression, nature of impairment, type of lesion, onset of the disease, treatment and outcome. Results: Of 76 patients analysed, 48(63.2%) were males and 28(36.8%) were females given a male to female ratio of 1:1.7. Their age ranged between 5 to 72 years with a mean of 39.83 ± 17.58 SD. The age range 21-40 years was most commonly affected, representing 31 (40.8%). The commonest cause of facial nerve paralysis was Bell’s palsy in 32(42.1%), followed by trauma 28(36.9%). Of the 28 (36.9%) that was caused by trauma, road traffic injury constituted 15(53.6%). Half (50.0 %) of the lesion affected right side of the face. Seventy (92.1%) was treated medically. Majority (37.0%) presented within one week of their symptoms. All the patients presented with deviation of mouth, followed by inability to close eye in 70 (92.1%). Higher proportion (88.2%) of our patients had lower motor neuron lesion. Conclusion: This study found that majority of our patients was young adults. Bell’s palsy was a major cause of facial nerve paralysis followed by trauma. Most of our patient presented early and did well on conservative treatment. High index of suspicion is essential especially when patients present with injuries involving head and neck region.


2017 ◽  
Vol 6 (2) ◽  
pp. 25-30
Author(s):  
Arkadiusz Paprocki ◽  
Robert Bartoszewicz ◽  
Kazimierz Niemczyk

Idiopathic facial nerve palsy, known also as Bell’s palsy, is a common condition encountered in everyday otolaryngological practice, and although the prognosis is fair, in case of incomplete recovery remains a marked physical disability for the patient. Despite of the development of diagnostic techniques, in most cases it is still impossible to point the etiologic factor, and therapy has to remain on empirical treatment. Material and method: In this article the review of literature on pathogenesis and therapy of idiopathic facial nerve palsy, published in years 2006–2016 was performed, presenting the articles with direct implications for everyday clinical practice. Results: According to presented articles, the importance of usage of combined treatment with steroids and antivirals, extended diagnostics for the presence of metabolic disorders(IGT) and surgical treatment with early facial nerve decompression in cases with severe degeneration of the fibers or recurrent paralysis were emphasized


2002 ◽  
Vol 111 (7) ◽  
pp. 616-622 ◽  
Author(s):  
Naohito Hato ◽  
Hisanobu Kisaki ◽  
Nobumitu Honda ◽  
Hirotaka Takahashi ◽  
Shingo Murakami ◽  
...  

Herpes simplex virus type 1 (HSV-1) has been proven to be a cause of Bell's palsy; however, the underlying pathophysiology of the facial nerve paralysis is not fully understood. We established a mouse model with facial nerve paralysis induced by HSV-1 infection simulating Bell's palsy and investigated the pathophysiology of the facial nerve paralysis. The time course of the R1 latency in the blink reflex tests paralleled the recovery of the facial nerve paralysis well, whereas electroneurographic recovery tended to be delayed, compared to that of the paralysis; these responses are usually seen in Bell's palsy. On histopathologic analysis, intact, demyelinated, and degenerated nerves were intermingled in the facial nerve in the model. The similarity of the time course of facial nerve paralysis and the electrophysiological results in Bell's palsy and the model strongly suggest that the pathophysiological basis of Bell's palsy is a mixed lesion of various nerve injuries.


1991 ◽  
Vol 105 (8) ◽  
pp. 625-627 ◽  
Author(s):  
P. J. Wormald ◽  
S. L. Sellars ◽  
J. C. de Villiers

AbstractBilateral facial nerve palsies are rare. This article details the Cape Townexperience of 24 patients with this condition seen over the past 20 years and highlights the three main groups in which these bilateral facial nerve palsies occurred. These are Bell's palsy, fracture of the temporal bones and sclerosteosis. Avariety of other rare causes was also found. Bell's palsy remains a diagnosis of exclusion though there has been some evidence to suggest implication of the Herpes simplex virus. The mechanism whereby temporal bone fractures cause bilateral facial nerve palsies is discussed. The clinical presentation and management of sclerosteosis is also discussed


2011 ◽  
Vol 5 (1) ◽  
Author(s):  
Rishi Agarwal ◽  
Lochana Manandhar ◽  
Paramveer Saluja ◽  
Bala Grandhi

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