Bells Palsy Ppt Free Download

Bell's palsy is a condition that causes sudden weakness in the muscles on one side of the face. In most cases, the weakness is temporary and significantly improves over weeks. The weakness makes half of the face appear to droop. Smiles are one-sided, and the eye on the affected side resists closing.

Bell's palsy is also known as acute peripheral facial palsy of unknown cause. It can occur at any age. The exact cause is unknown. Experts think it's caused by swelling and inflammation of the nerve that controls the muscles on one side of the face. It could be caused by a reaction that occurs after a viral infection.

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Symptoms usually start to improve within a few weeks, with complete recovery in about six months. A small number of people continue to have some Bell's palsy symptoms for life. Rarely, Bell's palsy occurs more than once.

Most doctors think that Bell's palsy is caused by damage to the facial nerve, which causes swelling. This nerve passes through a narrow, bony area in your skull. When the nerve swells -- even a little bit -- it pushes against your skull's hard surface, which affects how well the nerve works.

Bell's palsy is when you suddenly have weak or paralyzed muscles on one side of your face. It usually causes a drooping mouth, eyebrow, and eyelid. But it's not serious and usually clears up without any type of treatment in a few months.

Bell's palsy is an unexplained episode of facial muscle weakness or paralysis. It begins suddenly and worsens over 48 hours. This condition results from damage to the facial nerve (the 7th cranial nerve). Pain and discomfort usually occur on one side of the face or head.

Bell's palsy is not considered permanent, but in rare cases, it does not disappear. Currently, there is no known cure for Bell's palsy; however, recovery usually begins 2 weeks to 6 months from the onset of the symptoms. Most people with Bell's palsy recover full facial strength and expression.

The cause of Bell's palsy is not known. It is thought that it may be due to inflammation that is directed by the body's immune system against the nerve controlling movement of the face. Bell's palsy is sometimes associated with the following:

One uniformly recommended treatment for Bell's palsy is protecting the eye from drying at night or while working at a computer. Eye care may include eye drops during the day, ointment at bedtime, or a moisture chamber at night. This helps protect the cornea from being scratched, which is crucial to the management of Bell's palsy.

Bell's palsy is a type of facial paralysis that results in a temporary inability to control the facial muscles on the affected side of the face.[1] In most cases, the weakness is temporary and significantly improves over weeks.[4] Symptoms can vary from mild to severe.[1] They may include muscle twitching, weakness, or total loss of the ability to move one or, in rare cases, both sides of the face.[1] Other symptoms include drooping of the eyebrow,[5] a change in taste, and pain around the ear. Typically symptoms come on over 48 hours.[1] Bell's palsy can trigger an increased sensitivity to sound known as hyperacusis.[6]

The cause of Bell's palsy is unknown[1] and it can occur at any age.[4] Risk factors include diabetes, a recent upper respiratory tract infection, and pregnancy.[1][7] It results from a dysfunction of cranial nerve VII (the facial nerve).[1] Many believe that this is due to a viral infection that results in swelling.[1] Diagnosis is based on a person's appearance and ruling out other possible causes.[1] Other conditions that can cause facial weakness include brain tumor, stroke, Ramsay Hunt syndrome type 2, myasthenia gravis, and Lyme disease.[2]

Although defined as a mononeuritis (involving only one nerve), people diagnosed with Bell's palsy may have "myriad neurological symptoms", including "facial tingling, moderate or severe headache/neck pain, memory problems, balance problems, ipsilateral limb paresthesias, ipsilateral limb weakness, and a sense of clumsiness" that are "unexplained by facial nerve dysfunction".[11]

In December 2020, the U.S. FDA recommended that recipients of the Pfizer and Moderna COVID-19 vaccines should be monitored for symptoms of Bell's palsy after several cases were reported among clinical trial participants, though the data were not sufficient to determine a causal link.[23]

Bell's palsy is the result of a malfunction of the facial nerve (cranial nerve VII), which controls the muscles of the face. Facial palsy is typified by inability to move the muscles of facial expression. The paralysis is of the infranuclear/lower motor neuron type.

It is thought that as a result of inflammation of the facial nerve, pressure is produced on the nerve where it exits the skull within its bony canal (the stylomastoid foramen), blocking the transmission of neural signals or damaging the nerve. Patients with facial palsy for which an underlying cause can be found are not considered to have Bell's palsy per se. Possible causes of facial paralysis include tumor, meningitis, stroke, diabetes mellitus, head trauma and inflammatory diseases of the cranial nerves (sarcoidosis, brucellosis, etc.). In these conditions, the neurologic findings are rarely restricted to the facial nerve. Babies can be born with facial palsy.[25] In a few cases, bilateral facial palsy has been associated with acute HIV infection.

In some research, the herpes simplex virus type 1 (HSV-1) has been identified in a majority of cases diagnosed as Bell's palsy through endoneurial fluid sampling.[26] Other research, however, identified, out of a total of 176 cases diagnosed as Bell's palsy, HSV-1 in 31 cases (18%) and herpes zoster in 45 cases (26%).[18]

Bell's palsy is a diagnosis of exclusion, meaning it is diagnosed by elimination of other reasonable possibilities. By definition, no specific cause can be determined. There are no routine lab or imaging tests required to make the diagnosis.[12] The degree of nerve damage can be assessed using the House-Brackmann score.

Once the facial paralysis sets in, many people may mistake it as a symptom of a stroke; however, there are a few subtle differences. A stroke will usually cause a few additional symptoms, such as numbness or weakness in the arms and legs. And unlike Bell's palsy, a stroke will usually let patients control the upper part of their faces. A person with a stroke will usually have some wrinkling of their forehead.[27][28]

One disease that may be difficult to exclude in the differential diagnosis is involvement of the facial nerve in infections with the herpes zoster virus. The major differences in this condition are the presence of small blisters, or vesicles, on the external ear, significant pain in the jaw, ear, face and/or neck and hearing disturbances, but these findings may occasionally be lacking (zoster sine herpete). Reactivation of existing herpes zoster infection leading to facial paralysis in a Bell's palsy type pattern is known as Ramsay Hunt syndrome type 2. The prognosis for Bell's palsy patients is generally much better than for Ramsay Hunt syndrome type 2 patients.[33]

Steroids have been shown to be effective at improving recovery in Bell's palsy while antivirals have not.[12] In those who are unable to close their eyes, eye protective measures are required.[12] Management during pregnancy is similar to management in the non-pregnant.[7]

One review found that antivirals (such as aciclovir) are ineffective in improving recovery from Bell's palsy beyond steroids alone in mild to moderate disease.[37] Another review found a benefit when combined with corticosteroids but stated the evidence was not very good to support this conclusion.[8]

They are commonly prescribed due to a theoretical link between Bell's palsy and the herpes simplex and varicella zoster virus.[38] There is still the possibility that they might result in a benefit less than 7% as this has not been ruled out.[35]

When Bell's palsy affects the blink reflex and stops the eye from closing completely, frequent use of tear-like eye drops or eye ointments is recommended during the day and protecting the eyes with patches or taping them shut is recommended for sleep and rest periods.[28][39]

Physiotherapy can be beneficial to some individuals with Bell's palsy as it helps to maintain muscle tone of the affected facial muscles and stimulate the facial nerve.[40] It is important that muscle re-education exercises and soft tissue techniques be implemented prior to recovery in order to help prevent permanent contractures of the paralyzed facial muscles.[40] To reduce pain, heat can be applied to the affected side of the face.[41] There is no high quality evidence to support the role of electrical stimulation for Bell's palsy.[42]

Around 9% of people have some sort of ongoing problems after Bell's palsy, typically the synkinesis already discussed, or spasm, contracture, tinnitus or hearing loss during facial movement or crocodile-tear syndrome.[50] This is also called gustatolacrimal reflex or Bogorad's syndrome and results in shedding tears while eating. This is thought to be due to faulty regeneration of the facial nerve, a branch of which controls the lacrimal and salivary glands. Gustatorial sweating can also occur.

The number of new cases of Bell's palsy ranges from about one to four cases per 10,000 population per year.[51] The rate increases with age.[2][51] Bell's palsy affects about 40,000 people in the United States every year. It affects approximately 1 person in 65 during a lifetime.

Scottish neurophysiologist Sir Charles Bell read his paper to the Royal Society of London on July 12, 1821, describing the role of the facial nerve. He became the first to detail the neuroanatomical basis of facial paralysis. Since then, idiopathic peripheral facial paralysis has been referred to as Bell's palsy, named after him.[56]

A notable person with Bell's palsy is former Prime Minister of Canada Jean Chrtien. During the 1993 Canadian federal election, Chrtien's first as leader of the Liberal Party of Canada, the opposition Progressive Conservative Party of Canada ran an attack ad in which voice actors criticized him over images that seemed to highlight his abnormal facial expressions. The ad was interpreted as an attack on Chrtien's physical appearance and garnered widespread anger among the public, while Chrtien used the ad to make himself more sympathetic to voters. The ad had the adverse effect of increasing Chrtien's lead in the polls and the subsequent backlash clinched the election for the Liberals, which the party won in a landslide. 006ab0faaa