1. BELL’S PALSY BY: RANDY BONNELL BELL’S PALSY BY: RANDY BONNELL

2. Pathophysiology Pathophysiology  Actual pathophysiology is unknown  A popular theory is the nerve increases in diameter and becomes compressed as it courses through the temporal bone.

3. Frequency Frequency  The incidence of Bell palsy in the United States is approximately 23 cases per 100,000 persons

4. 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…….

5. 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

6. Race/Sex/Age 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

7. Lab Studies Lab Studies  No specific laboratory tests exist to confirm the diagnosis of Bell palsy

8. 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

9. 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

10. Prognosis 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

11. The groups are………. 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