Bell’s Palsy – Symptoms and Causes

Write short note on Bell’s palsy.
Or
Write causes and clinical features of Bell’s palsy.

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

Bell’s 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 after 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.

Read And Learn More: General Medicine Question And Answers

Bell’s palsy Clinical Features

Bell’s palsy Investigations

Electromyography is of prognostic importance.

• If signs of denervation are present after 10 days, i.e. axonal degeneration is present and recovery is incomplete or delayed.
• If there is incomplete denervation in less than 7 days the prognosis is good.
• Fibrillation potential after 2 weeks is suggestive of wallerian degeneration.

Bell’s palsy Management

• Local heat: Infrared or moist heat over the face or parotid region or both if there is tenderness of nerve trunk.
• Local treatment ofmuscles: The patient should massage the facial muscles with bland oil for twice a day for 5 min.
  The massaging movements should start from the chin and lower lip and are directed upwards.
  With return offunction the patient should practice movements of various muscles of face before a mirror.
• Prevention offacial sagging: Application of strips of adhesive tape is done to lift up the angle of mouth.
  Tape is attched to the temple and extends down in a V shaped fashion to upper and lower lips.
• 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: If seen under a week of onset. Prednisolone 40mg/day for 4 days and in tapering doses for over next 6 days helps by reducing secondary edema.
• Anti–virals: Acyclovir, Valacyclovir or Famciclovir in combination with steroids, ifstarted within 3 days ofonset.
• Surgery: Decompression of facial nerve in second or third week cannot inflence favorably natural course of Bell’s palsy. Cases which fail to recover after 9 months in them anastomosis of facial nerve with accessory or preferably hypoglossal nerve is considered, or plastic surgery in cases of total paralysis with atrophy of muscle.