Diseases Of Nerves And Muscles Important Question And Answers

Diseases Of Nerves And Muscles Important Question And Answers

Question. Write notes on Bell’s palsy.
Or
Write short note on Bell’s Palsy.
Or
Write in brief on Bell’s palsy.
Or
Write short essay on Bell’s palsy.

Answer. Bell’s palsy is an acute apparently isolated, lower motor neuron facial palsy.

Etiology

• Cold—It usually occurs after exposure to cold.
• Trauma—Extraction of teeth or injection of local anesthetic may damage to the nerve and subsequent paralysis.
• Surgical procedure—Such as removal of parotid gland tumor in which the facial nerve is sectioned can also cause facial paralysis.
• Tumors—Tumors of the cranial base, parapharyngeal space and infratemporal fossa cause 7th nerve palsy.
• Familial—Familial and hereditary occurrence is also reported in case of Bell’s palsy.
• Facial canal and middle ear neoplasm.
• Herpes simplex—viral infection.

Diseases of nerves and muscles

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Clinical Features

• Symptoms
  • Sudden following exposure to chill or without any apparent precipitating causing maximum paralysis in 24 hours.
  • Post auricular pain is common.
  • Spontaneous complaints of loss of sense of taste,hyperacusis (progressive loss of hearing and watering of the eye).
  • Sweating is less on the affected side.
• Signs
  • Forehead is not wrinkled and frowning is lost.
  • Eye of the affected side is not closed and on attempting closure eyeball turns upwards and outwards.
  • On showing teeth the lips do not separate on the affcted side.
  • Cheeks puff out with the expiration because of buccinator paralysis and food collects between the teeth and paralyzed cheek.
  • Base of the tongue is lowered.
  • Deafness may result.

Neuromuscular disorders

Management

• Local heat: Infrared or moist heat over the face or parotid region or both if there is tenderness of nerve trunk.
• Local treatment of muscles: Patient should massage the facial muscles with bland oil for twice a day for 5 min.
• Protection of eye: It is done with dark glass or eye patch.
• Mild zinc boric solution is used to wash the eye to prevent conjunctivitis.
• Corticosteroids: Prednisolone 60 mg/day along with amoxicillin 250 mg 8 hourly help in reducing edema round about the nerve.
• Heavy doses of vitamin B12 1000 µ gm per day IM is given.
• Galvanism: It is given two weeks after the onset of paralysis three times in a week.
• Surgery: Plastic surgery is preferred.