Bell's palsy or idiopathic facial paralysis[1] is a dysfunction of cranial nerve VII (the facial nerve) that results in inability

to control facial muscles on the affected side. Several conditions can cause a 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. Bell's palsy is characterized by facial drooping on the affected half, due to malfunction of the facial nerve (VII cranial nerve), which controls the muscles of the face. Facial palsy is typified by inability to control movement in the facial muscles. The paralysis is of the infranuclear/lower motor neuron type. Bell's palsy is a form of temporary facial paralysis resulting from damage or trauma to one of the facial nerves. It is the most common cause of facial paralysis. Generally, Bell's palsy affects only one of the paired facial nerves and one side of the face, however, in rare cases, it can affect both sides. Symptoms of Bell's palsy usually begin suddenly and reach their peak within 48 hours. Symptoms vary from person to person and can range in severity from mild weakness to total paralysis. These symptoms include twitching, weakness, or paralysis, drooping eyelid or corner of the mouth, drooling, dry eye or mouth, impairment of taste, and excessive tearing in the eye Bell's palsy weakens or paralyzes the muscles on one side of the face. When something is paralyzed, it can't move, so half of the person's face might look stiff or droopy. The paralysis does not last forever, but someone who has it will have trouble moving one side of his or her face. Bell's palsy can develop over a matter of days. Because it can happen suddenly, someone might think the problem is a stroke — when a blood vessel in the brain gets clogged or bursts. Like Bell's palsy, a stroke can paralyze a person's face. But Bell's palsy is caused by nerve trouble and isn't as serious as a stroke. Bell's palsy can be scary, but it usually doesn't last long and goes away without treatment. BELL’S PALSY Bell’s Palsy (facial paralysis) is due to peripheral involvement of the seventh cranial nerve on one side, which results in weakness or paralysis of the facial muscles. The cause is unknown, but possible cause may include vascular ischemia, viral disease (herpes simplex, herpes zoster), autoimmune disease, or a combination. Bell’s palsy may represent a type of pressure paralysis in which ischemic necrosis of the facial nerve causes a distortion of the face, increased lacrimation (tearing), and painful sensations in the face, behind the ear, and in the eye. The patient may experience speech difficulties and may be unable to eat on the affected side owing to weakness. MEDICAL MANAGEMENT The objectives of management are to maintain facial muscle tone and to prevent or minimize denervation. Steroidal therapy may be initiated to reduce inflammation and

Additional modalities may include electrical stimulation applied to the face to prevent muscle atrophy. Surgery may be performed if a tumor is suspected. blowing out the cheeks. NURSING MANAGEMENT Patients need reassurance that a stroke has not occurred and that spontaneous recovery occurs within 3 to 5 weeks in most patients. or surgical exploration of the facial nerve. and minimize denervation. TEACHING ABOUT MAINTAINING MUSCLE TONE · Show patient how to perform facial massage which gentle upward motion several times daily when the patient can tolerate the massage. · Instruct patient to avoid exposing the face to cold and drafts. relieve pain. Early administration of corticosteroids appears to diminish severity. · Remind patient and family of the importance of participating in health promotion activities and recommended health screening practices. . · Demonstrate the facial exercises. Teaching patients with Bell’s palsy to care for themselves at home is an important nursing priority. Facial pain is controlled with analgesic agents or heat applied to the involved side of the face. and whistling in an effort to prevent muscle atrophy.edema. for surgical decompression of the facial nerve. and for surgical rehabilitation of a paralyzed face. such as wrinkling the forehead. which reduces vascular compression and permits restoration of blood circulation to the nerve.

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