BELLS PALSY BY RANDY BONNELL Pathophysiology Actual pathophysiology
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 § 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
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