Bell’s Palsy: Symptoms Preceding and Accompanying the Facial Paresis (original) (raw)
Related papers
Understanding Bell's palsy –a review
Bell's palsy is a unilateral, lower motor neuron weakness of the facial nerve. Facial dysfunction has a dramatic effect on a patient's appearance, psychological wellbeing and quality of life. Bell's palsy has been described in patients of all ages, and is more common in adults than in children.The causes of the paralysis still remain unknown. Establishing the correct diagnosis is imperative and choosing the correct treatment options can optimize the likelihood of recovery. Hence this review deals with etiology, signs and symptoms, diagnosis and treatment management for Bell's palsy.
Bell's palsy: a summary of current evidence and referral algorithm
Family Practice, 2014
Spontaneous idiopathic facial nerve (Bell's) palsy leaves residual hemifacial weakness in 29% which is severe and disfiguring in over half of these cases. Acute medical management remains the best way to improve outcomes. Reconstructive surgery can improve long term disfigurement. However, acute and surgical options are time-dependent. As family practitioners see, on average, one case every 2 years, a summary of this condition based on common clinical questions may improve acute management and guide referral for those who need specialist input. We formulated a series of clinical questions likely to be of use to family practitioners on encountering this condition and sought evidence from the literature to answer them. The lifetime risk is 1 in 60, and is more common in pregnancy and diabetes mellitus. Patients often present with facial pain or paraesthesia, altered taste and intolerance to loud noise in addition to facial droop. It is probably caused by ischaemic compression of the facial nerve within the meatal segment of the facial canal probably as a result of viral inflammation. When given early, high dose corticosteroids can improve outcomes. Neither antiviral therapy nor other adjuvant therapies are supported by evidence. As the facial muscles remain viable re-innervation targets for up to 2 years, late referrals require more complex reconstructions. Early recognition, steroid therapy and early referral for facial reanimation (when the diagnosis is secure) are important features of good management when encountering these complex cases.
Bell's palsy clinical presentation, diagnosis, treatment and follow up: A case report
Bell's palsy is palsy of the seventh cranial nerve resulting from a dysfunction in the peripheral part of the seventh cranial nerve at the level of the pons or distal. This paper presents a case of a 24-year-old female patient who reported to the Department of Oral Medicine and Radiology with the chief complaint of loss of sensation on the right side of her face for 2 days. The clinical examination reveals gross facial asymmetry, loss of wrinkles when frowning, inability to close the right eye, and deviation of the smile line to the left. The exact etiology was not identified, so unilateral idiopathic Bell's palsy was diagnosed on the right side of her face. The patient was recommended steroids, antivirals, and multivitamins, followed by facial exercise. Full recovery was achieved 6 weeks after the presentation.
Report of 121 Cases of Bell's Palsy Referred to the Emergency Department
SBMU publishing, 2014
Introduction: According to the high incidence of Bell's palsy (IFP) and lack of clinical data regarding different aspects of disease, the present study investigated 121 Iranian patients with peripheral facial paralysis referred to the emergency department. Methods: In this retrospective study, all patients with peripheral facial paralysis, referred to the emergency department of Poursina hospital, Rasht, Iran, from August 2012 to August 2013, were enrolled. For all patients with diagnosis of Bell's palsy variables such as age, sex, occupation, clinical symptoms, comorbid disease, grade of paralysis, and the severity of the facial palsy were reviewed and analyzed using STATA version 11.0. Results: A total of 121 patients with peripheral facial paralysis were assessed with a mean age of 47.14±18.45 years (52.9% male). The majority of patients were observed in the summer (37.2%) and autumn (33.1%) and the recurrence rate was 22.3%. The most common grades of nerve damage were IV and V based on House- Brackman grading scale (47.1%). Also, the most frequent signs and symptoms were ear pain (43.8%), taste disturbance (38.8%), hyperacusis (15.7%) and increased tearing (11.6%). There were not significant correlations between the severity of palsy with age (p= 0.08), recurrence rate (p=0.18), season (p=0.9), and comorbid disease including hypertension (p=0.18), diabetes (p=0.29), and hyperlipidemia (p=0.94). The patients with any of following symptoms such as ear pain (p<0.001), taste disturbance (p<0.001), increased tearing (p=0.03), and Hyperacusis (p<0.001) have more severe palsy. Conclusion: There was equal gender and occupational distribution, higher incidence in fourth decade of life, higher incidence in summer and autumn, higher grade of nerve damage (grade V and VI), and higher incidence of ear pain and taste disturbance in patients suffered from IFP. Also, there was significant association between severity of nerve damage and presence of any simultaneous symptoms.
Bell’s palsy: Our experience and review of 30 cases
Otorhinolaryngology-Head and Neck Surgery, 2019
Bell's palsy [BP], named after Sir Charles Bells, is defined as acute onset peripheral facial nerve paralysis that is idiopathic, comprising of about 70% of the usual facial palsy cases. Many controversies exist about the exact diagnostic protocol and treatment options for Bell's palsy, but most commonly followed treatment options are corticosteroids with or without acyclovir, acupuncture, physiotherapy. In our study we are presenting clinicopathological 30 cases of BP with details regarding age of presentation, site of palsy, onset, and grade of paresis, treatment and sequelae. The purpose is to look over clinical characteristics of Bell's palsy to help provide information regarding the disease in our hospital setting and correlation with other similar studies in literature.
Bell’s palsy: A case report, review and management
IP Innovative Publication Pvt. Ltd., 2018
Bell's palsy is defined as an idiopathic unilateral facial nerve paralysis, usually self-limiting. Bell's palsy was first described by Charles Bell and is the most common cause of acute facial nerve paralysis (>80%). Immune, infective and ischemic mechanisms are all believed to play a role in the development of Bell’s palsy, but the precise cause remains unclear. From corticosteroids to botulinum injections, wide therapeutic approaches have been employed for treating bell’s palsy. Here, a case management and brief review of bell’s palsy is discussed. Keywords: Palsy, Idiopathic, Ischemic, Botulinum.
Chronic Bell's Palsy Literature Review and Case Report
Hrvatski časopis zdravstvenih znanosti
Bell’s palsy, or idiopathic peripheral facial nerve palsy is a neurologic condition characterized by unilateral weakness of facial muscles. The evidence-based guidelines mostly consider the acute treatment of Bell’s palsy. However, chronic cases of Bell’s palsy are not supported by strong evidence regarding treatment options, except for a weak recommendation to utilize physical therapy. This case report has presented an application of a combination of physical therapy modalities (Mirror Book Therapy, High Inten-sity Laser Therapy, and Acupuncture) within 10 weeks, to treat a patient with long-term sequelae. This combination of therapies has resulted in a significant improvement in the level of recovery measured by facial grading scales. However, further research is necessary to provide stronger evidence regarding the benefits of this treatment option.
Bell?s palsy is defined as an idiopathic paresis or paralysis of the facial nerve. The name was ascribed to Sir Charles Bell, who in 1821, demonstrated the separation of the motor and sensory innervation of the face. The incidence ranges from 15 to 40 cases per 100,000, with an equal distribution between the sexes. There is no racial predilection and advancing age may be a risk factor, although this remains controversial. The disease involves the right and left nerves in equal proportions and is recurrent in approximately 10% of cases it occurs bilaterally less than 1% of the time. About 8% of patients report a positive family history of Bell?s palsy, with a higher incidence in those with bilateral disease