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Bell's palsy is the involvement of what CN?
CN VII (one side)
What is BP?
(+) weakness/paralysis of the facial muscle.
- unilateral inflammation of the CNVII
- ipsilateral paralysis
Causes of BP:
- Possible causes:
- 1. vascular ischemia
- 2. viral disease (H. Simplex/ H. Zoster)
- 3. autoimmune disease
- 4. hemorrhage
- 5. tumor
- 6. local traumatic injury
S/SX of BP:
- 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.
Medical management of BP:
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
N/I for pt with BP:
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.
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