Special Needs

1. Special Needs Persons with Neurological Defects

2. Bells Palsy • Facial nerve paralysis • Damage to the facial nerve may cause imbalance of the face at rest as well as distorted • Asymmetrical facial expressions (e.g. smiling, laughing, grimacing, etc.).

3. Facial nerve paralysis • Functionally, facial nerve injury affects chewing, fluid retention while drinking, nasal breathing, corneal exposure, speech patterns, and communication skills. • At rest, the loss of facial muscle tone causes downward droopiness of the brow, eyelid, nostril, lip, and cheek on the paralyzed side of the face

4. Signs and symptoms • Onset is abrupt • Paralysis can be partial or complete on affected side • Symptoms can last for several hours • Pain in ears can precede palsy by a day or two • Symptoms often noticed upon wakening • The quicker signs and symptoms progress the more serious the paralysis and weakness

5. Damage to the facial nerve may cause imbalance of the face at rest as well as distorted, asymmetrical facial expressions (e.g. smiling, laughing, grimacing, etc.).

6. What causes Bell's palsy? • The cause of Bell's palsy is not clear. Most cases are thought to be caused by the herpes virus that causes sores • The nerve that controls muscles on one side of the face is damaged by inflammation. • Many health problems can cause weakness or paralysis of the face. If a specific reason cannot be found for the weakness, the condition is called Bell's palsy

7. Symptoms • Sudden weakness or paralysis on one side of your face that causes it to droop. This is the main symptom. It may make it hard for you to close your eye on that side of your face. • Drooling. • Eye problems, such as excessive tearing or a dry eye

8. Symptoms • Loss of ability to taste. • Pain in or behind your ear.. • Numbness in the affected side of your face. • Increased sensitivity to sound

9. How is it Treated • Most people who have Bell's palsy recover completely, without treatment, in 1 to 2 months • This is especially true for people who can still partly move their facial muscles • Asmall number of people may have permanent muscle weakness or other problems on the affected side of the face.

10. Dental Hygiene Care • Frequent dental hygiene appointments • Short appointments, preferably in the morning • A relaxed environment to reduce stress • Sensitivity to hot or cold environment needs to be addressed for the patient • In addition, the patient should have eyewear and airway protection

11. Dental Hygiene Care • Emphasize personal home care on afflicted side due to the oral musculature numbness • Establishing a brushing pattern • Remind patient to always rinse with water • Use of an oral irrigator would be helpful

12. Oral Clinical Findings • Other common effects are dry mouth, glossitis and candidiasis • Numbness could lead to oral trauma, ie cheek biting and increased debris on the side of the mouth that is affected • http://www.youtube.com/watch?v=wHTPfPcOHyo&feature=related

13. Amyotrophic Lateral Sclerosis (ALS) (Lou Gehrig's disease, Motor Neuron Disease)

14. Often referred to as "Lou Gehrig's Disease," is a progressive neurodegenerative disease. • The progressive degeneration of the motor neurons in ALS eventually leads to their death

15. When the motor neurons die, the ability of the brain to initiate and control muscle movement is lost With voluntary muscle action progressively affected, patients in the later stages of the disease may become totally paralyzed It is estimated that ALS is responsible for nearly two deaths per hundred thousand population annually

16. Approximately 5,600 people in the U.S. are diagnosed with ALS each year. • ALS is not contagious • ALS occurs throughout the world with no racial, ethnic or socioeconomic boundaries

17. Affects of ALS • About twenty percent of people with ALS live five years or more and up to ten percent will survive more than ten years and five percent will live 20 years • Riluzole, the first treatment to alter the course of ALS, was approved by the FDA in late 1995 • Since ALS attacks only motor neurons, the sense of sight, touch, hearing, taste and smell are not affected. For many people, muscles of the eyes and bladder are generally not affected

18. Clinical Care For An ALS Patient • Because hands and feet may be affected first, care should be given as to what devices should be given to the patient • Frequent DH appointments are encouraged • Electric toothbrush • Water pic, and or flosser • Morning appointments for the patient to minimize fatigue

19. http://www.youtube.com/watch?v=Dp4q8YNF9o4

20. Seizure Disorders

21. A brief disturbance of cerebral function caused by excessive abnormal neuronal discharge. • Seizures are common • 1% of children younger then 5 years will have at least one seizure, most likely associated with a high fever • Result from primary CNS dysfunction or underlying systemic or metabolic disorder

22. Characteristics • Include: a loss or altered state of consciousness, • Abnormal or cessation of motor activities • Abnormal sensory perceptions • And / or loss of bowel and bladder control

23. Epilepsy • A seizure disorder which excessive abnormal neuronal discharges from cerebral function disturbances are recurrent • Causes of only ½ of both childhood- onset and adult-onset have been found

24. Characteristics • Tonic-Clonic seizures ( grand mal) • Several phases • 1st phase- vague prodromal symptoms (aura) • Brief Bilateral muscle contractions • Tonic phase • Clonic phase

25. http://www.youtube.com/watch?v=02YpZ6sBSHk