What is Bell’s Palsy?

Is a condition that causes sudden temporary paralysis or weakness of the muscles on one side of

the face. It can be the result of an inflamed, swollen or compressed facial nerve that controls

facial muscles. The muscle weakness causes one side of the face to appear droop. As such, it can

be difficult to smile or close your eye on the affected side.

Causes

 Bell’s Palsy occurs when the 7th cranial nerve becomes swollen or compressed. However,

the cause of Bell’s palsy is unknown. It is believed that viruses trigger bell’s palsy. As

the 7th facial nerve swells and becomes inflamed in reaction to the virus present, it causes

pressure within the Fallopian canal (this is a bony canal through which the cranial nerve

travels to the side of the face), and this pressure leads to the restriction of blood and

oxygen to the nerve cells. Some of the viruses include;

 Herpes simplex- causes cold sores and genital herpes

 HIV- will damage the immune system

 Sarcoidosis- causes organ inflammation

 Herpes Zoster virus- causes chickenpox and shingles

 Epstein Barr virus- causes mononucleosis

 Lyme disease- caused by infected ticks

 Mumps

 Flu
 Symptoms

 Drooling

 Headache

 Loss of taste

 Difficulty eating or drinking

 Muscle twitches in the face

 Sensitivity to sound

 Facial weakness

 Difficulty pronouncing certain words

 Facial droop and difficulty making facial expressions

 Changes in the amount or tears and saliva produced

Diagnosis

 Blood test

 Electromyography

Lumbar puncture

Treatment

 Improve without treatment

 Over the counter pain medication

 Eye drops

 Corticosteroids
 Complications

 Damage to 7th cranial nerve

 Synkinesis

 Partial or complete blindness of eyes that won’t close

https://www.mayoclinic.org/diseases-conditions/bells-palsy/symptoms-causes/syc-20370028

https://www.healthline.com/health/bells-palsy#complications

Torticollis (Wryneck)

What?

Twisting of neck that causes it to rotate in an odd angel.

Types

Congenital Torticollis

This occurs due to the shortening of one of the sternocleidomastoid muscles and is present in

approximately 0.3-1.9% of all live births. The sternocleidomastoid muscles are two large

muscles found in the neck and they connect the back of the skill to the sternum and clavicle.

Factors that contribute to this type of torticollis are:

a. Fibrosis of the muscle due to bleeding and/or trauma during childbirth

b. Crowding within the uterus over the duration of the pregnancy

c. Abnormal development of the muscle

Acquired Torticollis
This type of torticollis develops as a consequence of a chronically strained neck position or it

may be due to a damage to the muscles that move the neck. This could be due to scar tissue, neck

arthritis or injury the SCM or trapezius.

Other source:

Fixed Torticollis

Usually referred to as acute torticollis and it is a complication that is usually as a result of issues

with the bone or muscular structure.

Temporary Torticollis

Factors that contribute to this type of torticollis are swollen lymph nodes, cold and injury to the

neck or head. Temporary torticollis usually disappears after a day or two.

Muscular Torticollis

This is the most common type of torticollis and results from tight muscles on either side of the

neck.

Cervical Dystonia/Spasmodic Torticollis

This causes contractions in the neck muscles and leads to uncontrollable spasms. Turning or

twisting the head to one corner is painful.

Klippel-Feil Syndrome

It is very uncommon and occurs when the bone structure of a baby’s neck is not formed

correctly. It could be as a result of the fusion between two neck vertebrae.

Causes.

This is dependent on type.

 Born injury
  Muscle spasm

 Sleeping in an awkward position

 Neck muscle injury at birth

 Slipped facets

 Herniated disk

 Viral or bacterial infections

Symptoms

 Neck muscle pain or pain down the spine

 Spasm of the neck muscle

 Awkward position of the chin

 Inability to turn head

https://www.hopkinsmedicine.org/health/conditions-and-diseases/torticollis-wryneck?amp=true
 References

Asher, A. (2022, July 27). Torticollis: Symptoms, causes, diagnosis, and treatment. Verywell

Health. https://www.verywellhealth.com/what-is-torticollis-296618

Kahn, A. (2021, November 18). Bell’s palsy: Causes, symptoms, diagnosis, treatment, outlook.

Healthline. https://www.healthline.com/health/bells-palsy#diagnosis

Michael, O. (2020, September 20). Torticollis: Types, causes, symptoms and treatment.

Healthtian. https://healthtian.com/torticollis/

National Institute of Neurological Disorders and Stroke. (2022). Bell's Palsy fact

sheet. https://www.ninds.nih.gov/bells-palsy-fact-sheet