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Bell's palsy
Mar 14, 2019 • Download as PPTX, PDF
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BELL’S PALSY
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Bell's palsy
1. BELL’S PALSY By: Josfeena Bashir Lecturer, BGSBU
2. DEFINITION Bell’s palsy (facial paralysis) is caused by
unilateral inflammation of the seventh cranial nerve, which
results in weakness or paralysis of the facial muscles on the
a!ected side
3. INCIDENCE Younger than 45 years of age Men &
women are a!ected equally
4. CAUSES Although the cause is unknown, Theories
about causes include Vascular ischemia, Viral disease
(herpes simplex, herpes zoster), Autoimmune disease, a
combination of all of these factors. NERVE TRAUMA
5. Risk factor The third trimester of pregnancy In
individuals with immune disorders such as HIV infection,
Individuals with diabetes. Viral upper respiratory
infection
6. Pathophysiology Etiology Inflammation of facial nerve
The inflamed, oedematous nerve becomes compressed to
the point of damage, or its blood supply is occluded,
Producing ischemic Necrosis of facial nerve Paralysis of facial
nerve
7. Clinical manifestation Onset of symptoms may be
sudden or may progress over a 2- to 5-day period Pain
behind the ear may precede the onset of facial paralysis
dry eye or tingling around the lips While li"ing, moving or
carrying an object keep it close to the body to prevent
unnecessary strain Avoid unnecessary bending or reaching
to an object. Flex knees to come close to the object Keep
work close to the body
8. Unable to Close The Eyelid, Wrinkle The Forehead,
Dysarthria & dysphagia The mouth is pulled toward the
una!ected side Drooling of saliva occurs, the a!ected
eye has constant tearing or lacrimation. Sense of taste is
lost over the anterior two-thirds of the tongue
9. Diagnostic evaluation History of the onset of symptoms
is used to diagnose Bell’s palsy. Observation of the patient
confirms the diagnosis. An EMG may be done. The
possibility of a stroke must be ruled out.
10. Management Corticosteroid therapy- to decrease
inflammation (eg, prednisone 1 mg/kg/day for 10 to 14
Acyclovir combined with prednisone is possibly e!ective in
improving facial function Eye care to maintain lubrication
and moisture if unable to close. May need to be patched
during sleep. Physical therapy, electrical stimulation to
maintain muscle tone. Nonsteroidal anti-inflammatory
drugs (NSAIDs) and analgesics to relieve pain Heat
application Massage Electrical stimulation
11. Surgical management Tarsorrhaphy
12. Complication Corneal ulceration Impairment of
vision Body image disturbance related to facial nerve
paralysis
13. Nursing management Test motor components of
facial nerve (VII) by assessing patient's smile, ability to
whistle, purse lips, wrinkle forehead, and close eyes. Observe
for facial asymmetry. Observe patient's ability to handle
secretions, food, fluids; observe for drooling. Assess
patient's ability to blink and speak clearly. Assess e!ect of
altered appearance on body image. Administer or teach
patient to administer artificial tears and ophthalmic ointment
as prescribed
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