Bell's Palsy

CN VII (one side)

(+) weakness/paralysis of the facial muscle.

• unilateral inflammation of the CNVII
• ipsilateral paralysis

UNKNOWN

• Possible causes:
• 1. vascular ischemia
• 2. viral disease (H. Simplex/ H. Zoster)
• 3. autoimmune disease
• 4. hemorrhage
• 5. tumor
• 6. local traumatic injury

• Distortions of the face
• Increased lacrimation (tearing)
• Pain in the face, behind the ears and in the eye
• Speech difficulties
• Unable to eat on the affected side (weakness)
• Inability to puff out cheeks; inability to smile
• Drooping eyelid; inability to close eyes

*pt recover completely and rarely recurs.

Obj: maintain facial muscle tone; px or minimize denervation.

PREDNISONE- corticosteroid;reduce inflammation and edema (reduce vascular compression and permits blood restoration to the nerve)

Analgesics- facial pain (or apply heat to the affected side)

Electrical stimulation- to px muscle atrophy

(+)tumor-surgery

Reassure pt the a stroke has NOT occurred; recovery: 3-5 weeks.

EYE CARE- cover eyes with a protective shield at night; eye ointment (to keep eyes closed at night); close paralyzed eyelid manually before going to sleep; wear sunglasses or eye goggles.

MAINTAINING MUSCLE TONE: facial massage (upward gentle motion); facial exercises (wrinkling the forehead, blowing out the cheeks and whistling-> px muscle atrophy)

*avoid exposure to COLD and DRAFTS.