BELL`S PALSY

Bell's palsy is a paralysis or weakness

of the muscles on one side of face.
Damage to the facial nerve that
controls muscles on one side of the
face causes that side of face to droop
•Bell’s Palsy & nerves affected
• Charles Bell – Scottish Surgeon (1774)
• Incident
– Trauma on facial nerves
– Compressed by Tumor
– Unknown Infection
• Branches involved – partial, fully
 Facial Nerves (Cranial Nerves
VII)

• Mixed nerve - facial movement and sensation

• Face - Smile, closing both eyes, Looking up
and contract the forehead, showing teeth, purse
the lips, blow out the cheeks.
• Taste - sour, sweet, bitter - is associated with
loss of taste in the anterior 2/3 of the tongue
• .
 Etiology
• The cause of Bell's palsy is not clear. Most cases are
thought to be caused by the herpes virus that causes cold
sores.
• In most cases of Bell's palsy, the nerve that controls
muscles on one side of the face is damaged by
inflammation.
• Many health problems can cause weakness or paralysis of
the face. If a specific reason cannot be found for the
weakness, the condition is called Bell's palsy.
.
 Symptoms of Bell's palsy include:

• Sudden weakness or paralysis on one side

of face that causes it to droop. This is the
main symptom. It may make it hard for pt.
to close the eye.
• Drooling.
• Eye problems, such as excessive tearing
or a dry eye.
• Loss of ability to taste.
• Pain in or behind the ear.
• Numbness in the affected side of face.
• Increased sensitivity to sound.
 Investigation

NONE
 Other Examinations

1. Physical examination – muscles

movement (asymmetry)
1. Eye – incomplete blinking
2. Eye lid rest (closed) – obstacles
3. Forehead, lips, expose teeth, blow out cheeks
against closed lips
2. Test to determine other factors
1. Blood – infection
2. X-ray – trauma, tumour
 Differential
Diagnose(Emergency medicine
by George Schwartz)

1. Gullaine-Barre`s syndrome
2. Myasthenia Gravis
3. Meningeal infiltration
4. Sarcoidosis
 Management

1.Approximately 70-80% - spontaneously

recover in the first 2-12 weeks of the
incident.
2.Dexamethasone 2 mg every 8 hours for 5
days - reduce edema of the facial nerve.
3.Eye pad - to protect the cornea
4.Cosmetic surgery may be considered.
 Complication & Prognosis

1.Paralysis of the facial muscles

2.The prognosis is not good if paralysis has
occurred
 Patient Education

1. Taking medicine prescribed regularly

2. All related with pt condition