| ID | 121 |
|---|---|
| Name | BELL’S PALSY |
| Cause | |
| Signs Symptoms | |
| Diagnosis | |
| Investigations | |
| Management | |
| Introduction | This is an idiopathic acute non-suppurative inflammation of the facial nerve within the facial canal leading to facial paresis. Bell’s palsy is accompained by oedema of the facial nerve within the facial canal. Recently a relationship of Bell’s palsy with Herpes simplex virus has been suggested but there is a little evidence to support it. It is common in all age group and in both sexes. |
| History | |
| Etiology | Etiology: The specific cause is unknown; but viral infection, vascular damage, trauma, and cold exposure have all been implicated. |
| Clinical Features | Clinical features: 1. The onset of symptom is usually subacute and there may be pain in the face and around the ear in the region facial canal. 2. A unilateral facial paralysis then develops. 3. The eye on the affected side cannot be closed. 4. The mouth is drawn over to the opposite side. 5. Saliva and fluids may escape from the angle of the mouth. 6. Food may collect between the teeth and the paralysed check when the patient is eating. 7. The affected side feels numb. On physical examination- 1. Paralysis of the upper and lower parts of the affected side of the face. 2. The lines of expression are flattened. 3. Patient is unable to wrinkle the brow or whistle or retract the angle of the mouth. 4. The eyes on the affected side cannot be closed: 5. Taste sensation is impaired on the anterior 2/3rd of the tongue (as the chorda tympani fibres are often affected). |
| Preventions | |
| Treatment | Treatment: 1. About 60% cases recover spontaniously within 2-12 weeks without treatment. 2. Steroids may reduce the inflammatory oedema. Dexamethasone 2mg 3 times daily (after food) for 5 days. Or, Prednisolone 60-80mg daily in divided doses for 4-5 days, followed by tapering of the doses over the next 7-10 days is a satisfactory regimen. |
| Complications | |
| Prognosis | Prognosis: Usually recovery occurs in more than 90% of the patients within 2-3 weeks to 2-3 months. Aproximately 5% of the patients have permanent loss of function & develop facial contractures & involuntary spasms of the facial muscles. |
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