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BELL’S PALSY BY: RANDY BONNELL. Pathophysiology. Actual pathophysiology is unknown A popular theory is the nerve increases in diameter and becomes compressed as it courses through the temporal bone. Frequency.
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Pathophysiology • Actual pathophysiology is unknown • A popular theory is the nerve increases in diameter and becomes compressed as it courses through the temporal bone.
Frequency • The incidence of Bell palsy in the United States is approximately 23 cases per 100,000 persons
Clinical manifestations • There is usually an abrupt onset of numbness or a feeling of stiffness or drawing sensation of the face • The face appears asymmetric, with drooping of the mouth and cheek • Other symptoms may be…….
More Clinical manifestations • Loss of taste • Reduction of saliva (on affected side) • Pain behind the ear • Ringing in the ear or other hearing loss • Difficulty swallowing
Race/Sex/Age • Incidence of Bell palsy appears to be slightly higher in persons of Japanese descent • No difference exists in sex distribution in patients with Bell palsy • The incidence is highest in persons aged 15-45 years
Lab Studies • No specific laboratory tests exist to confirm the diagnosis of Bell palsy
Medical management • There is no specific therapy for bells palsy. • Electrical stimulation or warm moist heat along the course of the nerve may be helpful
Nursing interventions • Protection of the eye when the eyelid does not close • Massage of the affected area is sometimes recommended • Do face exercises ( closing eyes, puffing out cheeks, wrinkling the forehead) • Keeping the affected eye moist
Prognosis • Prognostically, patients fall into 3 groups with roughly equal numbers in each group. • Most patients develop an incomplete facial paralysis during the acute phase • Of patients with Bell palsy, 85% achieve complete recovery
The groups are………. • Group 1 regains complete recovery of facial motor function without sequelae • Group 2 experiences incomplete recovery of facial motor function, but no cosmetic defects are apparent to the untrained eye • Group 3 experiences permanent neurologic sequelae that are cosmetically and clinically apparent